Jane O’Brien asks: What worries you most in your career?

Jane O'BrienGood Medical Practice (2006) and other GMC guidance is all motherhood and apple pie, right? You read it once and put it on a shelf, because it doesn’t really help out there in the real world.

But, when doctors email or ring us to ask for advice, we are almost always able to respond by referring to our guidance. Doctors are often surprised to find the booklet on consent or confidentiality, or Good Medical Practice (GMP) itself, can help them resolve their dilemma. The booklets are written in terms of principles – they apply to doctors in all specialties – and we understand it can be a struggle to see how it is relevant to the particular problem a doctor faces.

We identified the need for a way to bring the guidance to life, to make it engaging and interesting so that it influences and shapes doctors’ everyday professional practice.  Then we just had to find the right way to do it.

Doctors often tell us how useful they find case studies as a tool to explain how ethical principles work in the real world.  With that in mind we developed GMP in Action – a series of interactive waiting rooms on the GMC’s website where users can click on a patient to find out who they are and why they have asked to see the doctor. The story then moves to a consultation room and the user listens to the exchanges between the patient and their doctor (or in some cases between a doctor and their senior or junior colleague). At various stages the doctor is presented with an ethical dilemma and the user is asked to pick which of three options the doctor should take. Feedback is available on how each response compares with GMC guidance. 

In response to feedback from some of the 32,000 users of GMP in Action (since its creation in January 2008), we’ve increased the number of hospital-based scenarios and addressed some specific ethical issues in the more recent case studies. The issues addressed now range from whistleblowing to assessing capacity; from child protection concerns to relationships with former patients. We know from the enquiries we get to the standards team that the ethical dilemmas doctors face will vary enormously from day to day, and doctor to doctor. Although we’ll never cover them all, we want to provide guidance for decision-making in as many of those situations as we can.

That’s why we have asked the BMJ to run a poll this week to find out what issues are important to doctors.  The issue that tops the BMJ poll will be addressed in the new set of GMP in Action case studies, to be launched on the GMC’s website in the summer.

We know that being a doctor involves facing difficult problems and making complex decisions every day. The profession provides high quality care to the enormous majority of patients, and works hard in difficult circumstances to do so. GMP in Action is part of a drive to make the GMC’s ethical guidance for doctors accessible and relevant so it can support doctors to make the right decisions for their patients.

Jane O’Brien is an Assistant Director and Head of Standards at the GMC. View the poll here.

GMP in Action is on the GMC website at www.gmc-uk.org/gmpinaction. The fifth waiting room, containing the winning dilemma from this week’s poll, will be launched at the end of June.