Working with doctors Working for patients

Dr Grey - a 'portfolio' career

You may find this case study helpful if you:

  • have a 'portfolio' career and undertake multiple roles
  • undertake both medical and non-medical roles
  • undertake roles where you don't have contact with patients

Key points to consider

  • You only need to collect and reflect on patient feedback for roles you undertake as a doctor.
  • If you don't see patients, you will need to think more broadly about who can give you feedback on your practice, on which to reflect. This could be anybody you deal with on a regular basis other than your colleagues, such as a patient's family or carer, students or even suppliers and customers.
  • It may not always be appropriate to collect patient feedback for a particular role, or aspect of that role, that you undertake as a doctor. In such cases, you should discuss this with your appraiser and Responsible Officer.



Dr Grey has a varied 'portfolio' career, in which he has been working in several different roles for a number of years. He sees a small number of private patients, works as a magistrate, teaches in a university and occasionally acts as an expert witness in criminal proceedings.

Dr Grey is concerned that he has to collect patient feedback from all his roles. This will be challenging as he works for a range of organisations, each with its own governance arrangements, which he must follow. Also, he can't collect patient feedback in his medico-legal work as an expert witness, as the appellants he sees are not patients. His judicial colleagues agree that asking for feedback would not be appropriate and may breach judicial rules.

Dr Grey discusses these difficulties with his appraiser. The appraiser decides to get some advice from their Responsible Officer on which roles should be included.

How the doctor met our requirements

Dr Grey was able to collect feedback from a sample of patients in his private practice, using a benchmarked, anonymous feedback system.

The appraiser and Responsible Officer concluded that Dr Grey's role as a magistrate did not need to be included in his medical appraisal, as it is not a medical appointment and he doesn't use his medical knowledge and skills to perform this role.

After seeking advice, Dr Grey's appraiser advised that he did need to discuss his role as an expert witness at appraisal. But it was not appropriate for him to seek feedback from appellants. Dr Grey agreed with his appraiser what other supporting information he would bring to his appraisal for this role.

Dr Grey thought about who else he could ask for feedback, to complement that from his private practice patients. He was able to collect and reflect on a range of feedback from his various roles as a doctor; from clinical and academic colleagues, students, carers and relatives of private patients, and administrative and support staff.

At appraisal, Dr Grey was able to demonstrate he had collected supporting information from the whole scope of his medical practice. He was able to reflect thoroughly on it and consider whether he needed to make any changes to his practice.

Useful links

GMC expert witnesses guidance

Medical Defence union guidance - Acting as a medical expert witness

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