All doctors know that maintaining confidentiality is an important part of building up trust with patients. Here, Dr Stephanie Bown examines the medicolegal aspects of confidentiality

If you are a doctor and want to practise medicine in the UK, you need to hold GMC registration with a licence to practise. Given this requirement, we have carefully considered the appropriate criteria we require of members who produce medicolegal reports and/or act as a medicolegal expert.

As a collective whole, doctors are regarded as “professionals” both by the public and by their peers. They remain the most trusted profession among the public, which has been the case for many years. Individually, some doctors may fall short of the mark. But what do we mean by professionalism? And how much bearing does this definition have on the behaviours expected of a doctor? Firstly, we need to be clear about exactly what a profession is.

Today’s doctors are working in a constantly evolving environment, where many of the old expectations regarding the role of doctors, nurses and patients are being replaced by new ones. The roles themselves are changing – doctors are clinicians, leaders, teachers, managers, commissioners and purchasers of services.

Any doctor who specialises in a particular field would be expected to keep up-todate in that area. This would apply to all fields of medicine. Surgeons with a special interest would be expected to keep up-to-date with developments both in the field of general surgery and their area of special interest.

Patient A: I’ve got a very good GP now, I have got a GP who actually knows what fibromyalgia is, he’s prepared just to sit and listen, he listens a lot, he’ll let me try new medications, obviously because of my science background I probably know more about fibromyalgia than he does because I read so much in research papers, but he’s very willing to let me be a guinea pig and to work with me, which I think is important with a doctor/patient relationship, you’ve got to work on this path of chronic pain together.

Sometimes, when an adverse incident occurs, the GMC can take action if a doctor’s fitness to practise is called into question, which could be due to:

It is one of the great ironies that healthcare professionals are, generally, poor at taking care of their own health. Yet it is one of the core set of guidelines in Good Medical Practice that you have a responsibility to look after your health - if not for your own sake, then at least for your patients.

Honesty and integrity are central to probity and define how any professional person should act: being upstanding and law-abiding, and respectful of the trust placed in you by others.

Around 7% of allegations heard at fitness-to-practise hearings in 2011 were with regards to relationships with patients. As a doctor’s profession is defined by the duty of care to patients, it follows that standards of professionalism are entwined with the strength of the relationship between doctor and patient.

It is perhaps an understatement to say that teamwork is integral to the safe delivery of care within medicine, and the professional approach to good teamwork centres on good communication, mutual respect for others and proactively responding to any deficiencies in the team.

The GMC and the doctor in question are both invited to attend. The GMC is normally represented at the hearing by a barrister and the doctor is usually present and legally represented. Both parties may call witnesses to give evidence, who may be crossexamined by the other party. The Panel may also put questions to the witnesses.

Key decisions, observations and incidents that have influenced expectations around standards of professionalism over the years...

The government is introducing a new criminal offence for healthcare workers who wilfully neglect or ill-treat patients. The new offence may seem uncontentious but, in practice, it could have significant unintended consequences that could negatively impact on the professional lives of all healthcare workers, including doctors.

The Medical Innovation Bill, promoted by Lord Saatchi, proposes legal protection for doctors who try novel treatments for patients for whom standard treatments are no longer effective. The Bill is currently undergoing further scrutiny in the House of Lords.

Public exposure from complaints and claims can cause doctors to face a trial by media. In 2011, a UK GP was accused of sexually motivated conduct when he examined a patient’s chest – he shares his experience with Sara Dawson

The Olympic Games is a major event in the world’s sporting and cultural calendar. Almost inevitably, a number of Medical Protection members may be travelling to Brazil to attend the Rio do Janeiro Games.

The Care.data programme that was due to be rolled out in 2014 was delayed following criticism of the way the information campaign supporting it was implemented.