Medical supervisor: doctor to doctor
What is your role as medical supervisor?
As a medical supervisor, I will monitor your progress and keep the GMC updated about it. I will form an opinion on your health, and the progress that you are making under treatment, based on my observations and discussions with your doctor(s) and others.
These discussions will include details of any improvements in your health, your current treatment, your prognosis and results of any testing carried out by your doctor or at your workplace.
In addition I will seek input from your employer or workplace where possible in order to form a view on your current practice and whether the restrictions placed on your registration are working.
This helps me to produce periodic reports for the GMC about your progress, treatment and employment issues.
My primary responsibility is to the GMC to generate these reports. I am also responsible for letting the GMC know about any significant problems and/or breaches of undertakings or conditions.
What qualifies you for this role?
Most supervisors are consultant psychiatrists who have had experience in working with general psychiatry. They may also have specialist experience of forensic psychiatry, occupational health or addictions. In addition I receive training and regular updates from the GMC on matters of policy and new developments.
What happens at the first supervision meeting?
The first meeting is quite structured and begins with an introduction to the role of the supervisor and the background to your case. We then usually talk through each of the conditions or undertakings and make sure the doctor understands what is expected of them. We also discuss any treatment and workplace concerns. Finally, we will discuss confidentiality issues.
If substance misuse or dependency is one of the problems the doctor is being treated for, then they may be monitored through toxicology (eg blood, urine or hair tests) in any of their supervision sessions.
How often will meetings take place?
It depends on your particular health concerns and how you are progressing. It also depends on how aware you are of your health problems and the impact these may have on patient safety.
I will stay in contact with you regularly by telephone or email and a face-to-face meeting at least every couple of months.
As you recover, we may discuss appropriate changes to any undertakings or conditions. However, the decision on whether to change your restrictions lies with the GMC and not with me.
Can you describe my relationship with you as my supervisor?
Whilst my primary responsibility is to advise the GMC on your fitness to practise in the context of your illness, I will also try to support you in your return to, or remaining in, work. I will offer advice about your medical practice and act as a go between for you and your employer if this is helpful.
Our relationship is based around regular meetings. Over time I aim to establish a bond of trust between us as your health improves and to provide support tailored to your needs as they change.
Can you provide me with treatment?
I cannot treat you myself but I can offer support and advice and put you in touch with others who can.
What kind of guidance can you give?
I support and encourage the doctors I work with through their recovery and advise them about the importance of complying with their undertakings or conditions.
I can also point you to support groups, facilitate contact with deaneries and medical directors and advise you on any return to work issues. I also help doctors understand the GMC and its procedures.
How will you assess whether or not I am making progress?
I consider a number of sources of information when assessing how a doctor is progressing. One of these is to ask you how you view your own progress and health. Workplace reports are submitted by doctors and by your workplace reporter.
I will also look at feedback from a treating psychiatrist or GP and the results of any tests agreed with a doctor in relation to substance issues.
Finally, views of any family members, a partner or others (for example the Doctors and Dentists Group or other support group) that you have agreed to be involved can also be taken into account.
Will you be involved in liaising with my employers?
I may discuss your progress with your workplace reporter, but details of your health condition will not be discussed without your consent.
I may, however, discuss how many hours you should work, your on-call responsibilities, and so on. I would normally also discuss any adjustments that need to be made with you, occupational health and your treating doctors.
What information will you need from my workplace?
I will agree a main point of contact with your employers, which is usually your workplace reporter.
The feedback they give me may include reports about your performance at work including communication and interaction with colleagues and patients, any complaints, sickness absence or other concerns.
If there are any significant concerns raised then I would normally arrange a meeting or phone call with you.
What information will you need from the people involved in my treatment?
I will need to confirm that you have attended any planned appointments, continued remission and stability, and any changes in your medication or treatment.
I will discuss with them any triggers which may have affected your stability, the results of any monitoring arrangements, and your care plan. We will also be assessing your understanding of your health condition.
How will you take into account any views that I have about my treatment?
A doctor’s own account of their health and views about their treatment are very important.
This discussion allows you to demonstrate that you understand your condition and the support network and other plans that have been put in place to maintain remission and prevent relapse.
During each meeting, I will ask you about your condition, your compliance with treatment and your insight into it.
What information do you share with the GMC?
The GMC requests a progress report every three to six months. There is a standard format for the report which asks for an update on your progress in relation to health, employment, compliance with conditions/undertakings, impairment and to give an opinion on your fitness to continue to practise and any changes to undertakings that might be appropriate.
Tests results will be copied to the GMC. A copy of each progress report will be provided to you, and there is an opportunity for you to discuss this with your medical supervisor.
What measures do you take to protect my privacy?
Information about your health, including any relevant undertakings or conditions which relate solely to health is strictly confidential.
This means that information about your health will not be disclosed to anyone without your consent and will not be disclosed to your employer, workplace supervisor or responsible officer.
Only undertakings or conditions which relate to your practice will be published on the GMC’s website and disclosed to enquirers. If you have any concerns regarding your privacy and confidentiality, you should tell me (your medical supervisor).
What will you do if I am not making progress?
Any concern about progress will be discussed with you in the first instance by the person who has raised the issue.
If the concerns are not serious, then your medical supervisor will ask those involved in your treatment to review the care plan.
If there was a significant crisis, such as sudden and severe deterioration in your health it is likely that I will ask you to stop work until the situation is reviewed.
What do you expect from me?
At the start of the process I will agree with you a monitoring plan for your conditions or undertakings. You are expected to follow this plan and report any concerns to your supervisor.
If any issue arises regarding a relapse of health, change of employment or any new complaints or concerns, you are expected to be proactive in contacting me at the earliest opportunity, outside planned appointments if necessary.
You should remain contactable and provide any changes of address, phone numbers and other contact details to me.