Read feedback to our polls and surveys in September. Your feedback will be taken into account during the review of Good Medical Practice.
Read a summary of your feedback to our September poll and, given the overwhelming response, you can also read about the issues surrounding doctors’ lives outside medicine in more detail and the approaches taken by other professional bodies.
Do you think the GMC should regulate doctors' lives outside medicine?
In September we asked you whether you thought the GMC should regulate doctors' lives outside medicine. We had a very large response to this poll with 1167 of you taking part!
1100 (94%) of you thought that the GMC should not regulate doctors lives outside medicine; 54 (5%) thought we should and 13 (1%) were not sure.
Of those of you that thought the GMC should not take an interest in doctors lives outside of the clinical environment, some of the common themes were that it would be a breach of the right of all individuals to a private life, and that it had nothing (or very little) to do with clinical practice.
Here are some of the comments you submitted:
- ‘If a doctor's behaviour is legal and doesn't affect their clinical practice, it is none of the GMC’s business.’
- ‘What doctors do in their own time is entirely up to them, so long as it is lawful, they have no less of a right to privacy than any other member of the population.’
- ‘As long as doctors live within the law outside of work, I don't believe the GMC has any right at all to dictate how doctors live their lives. The public realise that doctors are also human beings who enjoy life outside of work as much as anyone else - let us be real people, it will make us better doctors!!’
- ‘The conduct of doctors both within the work place and in their private lives forms the basis for the trust which patients have in them. Without this trust doctors would not be privy to the information that they rely on to make balanced judgements on the cause of symptoms or distress.’
- ‘The distinction lies in how much control is permitted to the GMC, and under what circumstances should the control be exerted; given the subjective nature of determining what constitutes a fitness to practise issue and the extent of action required for instance, safeguards must also be in place to prevent abuse.’
- ‘People have to be able to trust their doctors. If individuals behave in an unequivocally untrustworthy way in any part of their lives, the GMC should be interested. And that is all the GMC should be interested in outside working hours. What exactly constitutes untrustworthy is of course not easily defined!’
- ‘Surely it depends on whether the activity is likely to affect the doctor's practice. e.g. taking illegal drugs could affect their performance, but a speeding ticket shouldn't be an issue.’
- ‘I think the key question here is about what does one mean by regulation. I am aware that some doctors have been referred to the GMC and censured for comments to websites only accessible to doctors. What if our views are different to the mainstream but still valid, could I be censured for holding my stance. I would agree that some things are absolutes, eg drink-driving, child pornography, inappropriate relationships being examples, but other minor convictions, or minor indiscretions should be disregarded unless they are part of a pattern in a doctor. We all should be allowed to make small mistakes without fearing the GMC.’
Given the very large response to this question, we have decided to ask a specific question about doctors lives outside medicine when formal consultation starts later this month. Sign up to our email updates to find out when the consultation goes live.
Doctors lives outside medicine
“The reputation of the profession is more important than the fortunes of any individual member. Membership of a profession brings many benefits but that is part of the price”
Master of the Rolls in the case of Bolton v Law Society  1WLR 512
This is a phrase which has been cited in many subsequent cases involving doctors both in the courts and in the GMC’s fitness to practise determinations. It is used in cases where doctors’ actions are judged to have undermined public trust in the profession, but where the doctor’s professional competence, skills or knowledge are generally not in question.
In Good Medical Practice we focus on the purpose of the ‘reputation of the profession’, which is that patients should be able to trust any registered doctor. We say at paragraph 57:
- 'You must make sure that your conduct at all times justifies your patients’ trust in you and the public’s trust in the profession.’
Most commonly fitness to practise cases citing this paragraph arise where doctors are convicted of criminal offences, accept cautions or equivalent sanctions across the UK. But occasionally we also take action on doctors’ registration as a result of doctors’ behaviour in the public sphere, which while not illegal, may undermine patients’ or public trust in the profession.
The rationale for this has always been that patients need to trust their doctors absolutely. Many patients will be vulnerable when they seek medical care and need to be able to trust doctors implicitly.
For the doctor/patient relationship to be successful, patients must trust doctors to be honest and to act with integrity in their patients’ interests. Patients do not want their doctors to have criminal convictions, particularly for violent or sexual offences, and they may not want to be treated by a doctor whose conduct they find morally repugnant or unacceptable. For example, many people would not want to confide in, or agree to be examined by, a doctor found guilty of crimes relating to child abuse or child pornography, even though there was no evidence that the doctor was clinically incompetent.
But taking a contrary view, some people may reasonably argue that doctors place in society (as revered members of the community, given automatic respect and deference) has evolved and changed in recent years.
They are trained and expert in a profession, not plaster saints of whom no more should be expected in their lives beyond medicine than of anyone else. A doctor who is convicted of a criminal offence faces the same penalty as any other citizen and should not be subjected to the double jeopardy of the GMC’s fitness to practise procedures. What matters most is a doctor’s clinical competence and not what they said in their tax return or on their Facebook page. Further, they have a right to respect for their private and family life, just as any other citizen does. The GMC should therefore limit its role to the regulation of doctors’ professional lives.
What happens elsewhere
Listed below are extracts from codes of practice and guidance issued by other professional bodies:
The General Dental Council says that dentists must:
- ‘Justify the trust that your patients, the public and your colleagues have in you by always acting honestly and fairly….'; and
- 'Maintain appropriate standards of personal behaviour in all walks of life so that patients have confidence in you and the public have confidence in the dental profession.’
The Institution of Civil Engineers (ICE) Rules of Professional Conduct says:
- ‘Being a member of the ICE is a badge of probity and good faith, and members should do nothing that in any way could diminish the high standing of the profession. This includes any aspect of a member’s personal conduct which could have a negative impact upon the profession.'
The Health Professions Council says:
- ‘You must behave with honesty and integrity and make sure that your behaviour does not damage the public’s confidence in you or your profession.’
Having read this summary, if you have any further thoughts about the GMC taking an interest in doctors lives outside medicine, you can email us at firstname.lastname@example.org
For background information you can also read views and opinions, including a view from the Solicitors Regulatory Authority on What do you expect of your doctor outside medicine?
Julia's Day: Episode Four
More than 200 of you voted on what our fictional GP should do, after reading about her ethical dilemma at the end of Episode four.
You can view the full poll results by clicking on the feedback tab on the Julia's Day page.
...to take part in this month's activity and sign up to our email updates to stay in touch with the review.