What makes a good doctor?

Chair, GMC

"Doctors have the enormous privilege of touching and changing lives. Through all the changes driven by research and public expectations, some of the art and science of medicine has endured down the ages and defines medicine as a profession, whatever a doctor's area of practice.  Doctors:

• synthesise conflicting and incomplete information to reach a diagnosis;
• deal with uncertainty - protocols are great, but doctors often must work off-protocol in the best interests of the patient, for example when the best treatment for one condition may make a co-existing condition worse;
• manage risk - many patients are alive today because doctors took risks and as doctors we bring all our professional experience to bear on knowing when acceptable, informed and carefully considered risk ends and recklessness begins - and we share that information openly and honestly with our patients, always respecting that the final decision is theirs;
• recognise that change both in medicine and society is constant, ensuring that those standards which are immutable are preserved while those that are simply a product of their time are consigned to history
• carry and accept ultimate responsibility for our actions.

Those of us who practise and teach medicine now are merely the custodians of those core values which were passed on to us by earlier generations and which we in turn will pass on to those who come after us. It is these values and these qualities which define a good doctor: they are timeless and long may they remain so."

Chairman, the Environment Agency

Diagnosing the Good Doctor

"The relationship between doctor and patient has changed almost beyond recognition in recent years. Deferential respect for paternalistic wisdom has given way to a much more equal standing between the two parties - though at its best it remains one that is based on respect for knowledge, expertise and experience on the one hand and respect for the humanity of the patient and their wish to know on the other.

I remember one of my doctors saying to me - shortly after my HIV diagnosis - that he couldn't say for certain what the prognosis was going to be, but that "I needed to learn to live with uncertainty". It's actually not a bad lesson for life generally, but it embodied exactly the approach I needed from my doctor. It accepted that I (like many other patients in a similar position) knew quite a lot about the risks, the hopes, the state of knowledge, and the things that weren't known, about this disease. But based in an expert viewpoint, it helped me to understand all of those things better. Recognising the knowledge and experience of the patient as well as the knowledge and experience of the doctor, and building on that rather than ignoring it: this is what good doctoring is all about.

There will be times, of course, when the patient knows little or nothing, is scared and troubled, and may have imagined the very worst. Then a doctor's calm reassurance is needed. When the patient knows a lot more, has researched a lot more, calmness and reassurance (and sometimes gentle correction) may still be the order of the day, but in a rather different way. In both cases, though, respect is what matters. It's more than half the battle."

Northern Ireland Nurse of the Year 2010

 "To me and my patients I have always found the following qualities essential ingredients for the making of a good doctor:

• Approachable, confident, decisive, intelligent, interested, compassionate and caring - being able to absorb people's pain and anxieties without losing focus, treating patients as a human being rather than a symptom or collection of symptoms.  Their integrity is without question.
• Takes time to listen and communicate honestly and effectively with patients, relatives, staff teams, managers, peers and dignitaries pitched at the appropriate level whilst putting everyone at ease.
  Respect for everyone's capabilities and their contribution to the team.  Knowing everyone's name in the team regardless of their position.  Being fair and non-judgmental.
• Having technical skills, being competent, knowledgeable using evidence based practice.  The ability to remain calm and proficient when under pressure and still make clear and timely decisions.
• Inspiring, always learning and teaching without fear of humiliation, lead and train the team as a team.
• Trustworthy, loyal, dedicated, thorough, a mentor, reliable, respected rather than revered and dedicated to up holding their Hippocratic Oath.
• A visionary leader who is confident about their standards and stands firm to up hold their and the team's values and beliefs.

A great doctor knows and remembers his/her patients and treats them with a kind heart and gentle hands as if they were one of their own family, dedicating their working life of service to creating and preserving health."