Ethics, Law, and Medical Practice

By Kerry J. Breen; Vernon D. Plueckhahn et al. | Go to book overview

QUALITY ASSURANCE IN PRIVATE MEDICAL PRACTICE
Some doctors in independent practice are not involved in peer review, audit or QA, despite the existence of the College recertification requirements. At present, there is no statutory obligation to undertake QA in private medical practice. The ethical obligation to provide competent patient care and the desire to provide better care in a competitive environment may motivate doctors to undertake QA in private practice. If so, consideration might be given to a range of relatively simple measurements proposed by Duggan2, which included studies of
Patient satisfaction;
Effectiveness of appointment systems;
Efficiency of written communications;
Efficiency of office systems;
Adequacy of patient records; and
The quality of the equipment and environment of the practice.

FUTURE DIRECTIONS

Future developments in the area of quality assurance and clinician performance are likely to be driven by governments seeking more efficient use of resources (see also Chapter 11). These may include linking state funding under the Medicare agreement to the collection of clinical performance indicators by hospitals, with punitive rather than educational implications. There is also the likelihood that health care outcome data for hospitals and possibly for individual doctors will be published.


REFERENCES

1 Recertification. Information manual. Royal Australasian College of Surgeons, 1994.

2 Duggan J M. 'An introduction to quality assurance for clinicians.' Discussion paper. Quality Assurance Committee of the Board of Continuing Education. Sydney: The Royal Australasian College of Physicians, 1994.

3 Clinical indicators: Users' manual. 2nd ed, Melbourne: ACHS Care Evaluation Program, 1993.

4 Field M J, Lohr K N (eds). Clinical practice guidelines: directions for a new program. Washington: National Academy Press, 1990.

5 Rice M S. "'Clinical practice guidelines. Position statement of the Australian Medical Association.'" Med J Aust 1995; 163: 144-5.

6 National Health and Medical Research Council of Australia. Quality of Care and Health Outcomes Committee. Guidelines for the development and implementation of clinical practice guidelines. Canberra: AGPS, 1995.

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