Professor Mike Pringle states that ‘without revalidation, we will be mired in the spiral of mistrust' (Revalidation is a reality GPs must accept).
Really? Where is the evidence for this? In fact, surveys regularly show doctors to be at the top of the public's list of trustworthy professions, with politicians and second-hand car salesman at the bottom. It appears we are undertaking a very expensive and time-consuming process to address a problem that does not exist.
Would revalidation have picked up Harold Shipman? Many doctors feel he would probably have been an appraiser.
I do not wish to be complacent. There are admittedly some under-performing doctors, but could we not consider a more focused approach to dealing with them, rather than making the entire profession jump through meaningless hoops?
There are already indicators of poor practice – prescribing, referrals and complaints which have been upheld. It is likely the PCT or health board and LMC secretaries will have a fairly good idea of who these problem doctors are.
Could we not use these sorts of screening procedures to identify possible problem doctors and examine them in more depth, along with a small number of randomly chosen others for benchmarking purposes?
This would be a much more efficient use of everyone's time and would be more likely to identify under-performing doctors, in my view.
The current appraisal process is in danger of being too superficial to pick up problems. It will also irritate the profession and waste its time.
From Dr Graham Brown, Kirkcaldy, Fife
