care by other health professionals and also by pastoral care workers and chaplains.
Changes in models of health care delivery are very challenging to doctors. For some individuals these changes led to increased tensions between professional groups and have contributed to professional dissatisfaction. Other doctors have risen to the challenge and gained greater respect from the other professions for being willing participants in teams.19 While the primacy of the medico-legal responsibility for patients resting with doctors remains generally true, this does not apply to people who refer themselves directly to physiotherapists, chiropractors or nurse practitioners. Most people when ill still expect doctors to be competent to take charge of serious or life threatening illness, yet can be ambivalent about the power they thus cede to doctors. This applies also to other health professionals who become ill. Medical students need to be aware of these tensions and challenges, and in their training be provided with the means of best meeting them. This will include developing a clear understanding of the roles and capabilities of other health professionals, a respect for other health professionals, a positive approach to team work and understanding leadership roles and enhanced communication skills.
These issues are covered more fully in Chapter 14 which emphasises the professional responsibilities of doctors to work collaboratively and respectfully with other health care professionals. Positive attitudes to these responsibilities need to be encouraged and developed in students during their medical courses.
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