CODE OF PROFESSIONAL CONDUCT

Summary

The aim of this Code of Professional Conduct is to set out general principles in relation to the practice of medicine.

The Code applies to all medical practitioners working at ADK Hospital and sets down standards to be observed in their treatment of patients, their dealings with other practitioners and health care workers, and registration and other authorities.

The standards set out principles in relation to a medical practitioner’s:

• Clinical competence and performance
• Professional and ethical obligations
• Relationships with colleagues
• Probity in professional practice

The standards detailed in the Code are those, which we expect a competent doctor to meet.

The Code of Professional Conduct is addressed to doctors, but is also intended to let the public know what they can expect from doctors.

The Code is based on a set of guidelines adapted with permission from the Australian Medical Council, the New South Wales Medical Board, and the Medical Council of New Zealand.

How the Code of Professional Conduct applies to you:

ADK Hospital expects all doctors working at the hospital to be competent. It is the responsibility of competent doctors to be familiar with the Code of Professional Conduct and to follow the guidance it contains.

The Code of Professional Conduct will be used in performance appraisals and where any performance assessment needs to be made, in relation with a complaint or otherwise.

Standard 1:Clinical competence/performance

Principles

You must possess and apply adequate knowledge and skill in the practice of medicine.

1.1. Good clinical care

Good clinical care entails:

• An adequate assessment of the patient’s condition, based on the history and clinical signs and appropriate examination;
• Communicating with patients respectfully and with the assistance of a skilled interpreter where necessary;
• Where appropriate, providing or arranging investigations or treatment;
• When necessary, taking suitable and prompt action; and
• When indicated, referring the patient to another practitioner

1.2. Providing Care

In providing care you should:

• Recognize and work within the limits of your clinical competence when making diagnoses and when giving or arranging treatment;
• Be willing to consult colleagues;
• Keep clear, accurate and contemporaneous patient records;
• Pay due regard to effectiveness of care and the use of resources;
• Prescribe only the treatment, drugs or investigations that serve the needs of the patients; and
• Do your best to provide appropriate treatment in an emergency.

1.3 Maintaining your competence (knowledge and skill)

In order to maintain your competence (knowledge and skill) you must:

• Participate in educational activities, relevant to your area of practice, which develop and maintain your competence and performance throughout your working life and keep records of the continuing professional development;
• Observe and keep up to date with the laws and codes which affect your work

1.4 Maintaining your performance

• In order to maintain your performance you must:
• Ensure that you report to authorities where the premises or equipment are inadequate;
• Work with colleagues to monitor and maintain your awareness of the quality of the care you provide;
• Take part in regular and systematic medical and clinical audit, and record all data carefully and honestly;
• Respond constructively to assessments and appraisals of your professional competence and performance;
• Respond to the results of audit to improve your practice, for example, by undertaking further training.

Standard 2: Professional/ethical observations

Principles

You must observe professional and ethical obligations. These include:

• Undertaking education, teaching and training responsibilities;
• Providing honest assessment of the performance of colleagues;
• Maintaining trust with patients through your interaction with them;
• Putting patients first while putting aside your own personal views;
• Responding appropriately to situations in which a complaint is made about treatment provided by you, or treatment that is unsuccessful;
• Dealing appropriately with the next of kin of deceased patients;
• Arranging appropriate alternative treatment when the doctor/patient relationship deteriorates;
• Ensuring that your professional position is not abused through improper dealings with patients;
• Ensuring that your health does not put patients at risk;
• Ensuring, through reporting, that other practitioners do not place patients at risk through their health, behavior, conduct or performance;
• Reporting adverse events relating to the professional performance or conduct of colleagues.

2.1 Maintaining trust with and providing information to patients

Successful relationships between doctors and patients depend on trust. To establish and maintain that trust you should:

• Listen to patients and respect their views;
• Treat patients politely and considerately;
• Respect your patient’s privacy and dignity;
• Observe professional boundaries with patients. This includes not engaging in personal relationships or sexual behavior with patients.
• Treat information about patients as confidential. (There may be circumstances where the public interest requires that patient information may be disclosed to a third party by law. You should seek appropriate advice in these circumstances.);
• Give patients full information about their condition and treatment, outlining the risks and benefits, and prognosis. You should provide this information to the parent, guardian or person responsible where patients lack the maturity or ability to understand etc;
• Give information to patients, parent, guardian or person responsible in a way they can understand;
• Wherever possible, check that the patient, parent, guardian or person responsible has understood the information given and the course of action proposed, and that they consent to it, before you provide treatment or investigate a patient’s condition;
• Respect the right of patients to be fully involved in all decisions about their care;
• Respect the right of patients to decline treatment or decline to take part in teaching or research;
• Respect the right of patients to a second opinion; and
• Be readily accessible to patients and colleagues when you are on duty.

2.2 Putting patients first

• You should recognize the fundamental role of the patient, parent, guardian or person responsible in decision-making about the treatment of the patient.
• You should give priority to the investigation and treatment of patients on the basis of clinical need, bearing in mind the needs of other patients.
• The investigations or treatment you provide or arrange should be based on your clinical judgment of the patient’s needs and the likely effectiveness. You should not allow your views about a patient’s lifestyle, culture, beliefs, race, color, gender, sexuality, age, religion, social, political, economic or insurance status, to prejudice the treatment you provide or arrange.
• If you feel that your beliefs might affect the treatment you provide, you should explain this to patients, tell them of their right to see another doctor, and where appropriate, refer them to another doctor.
• You should not refuse or delay treatment because you believe that a patient’s actions have contributed to the patients’ condition, or because you may be putting yourself at risk. If a patient poses a risk to your health or safety, you may take reasonable steps to protect yourself before investigating their condition or providing treatment.
• You must act in your patient’s best interests when making referrals and providing or arranging treatment or care. You must not ask for or accept any inducement, gift or hospitality, which may affect or be seen to affect your judgment. You must not offer such inducements to colleagues.

2.3 When things go wrong

• Patients who complain about the care or treatment they have received have a right to expect a prompt and appropriate response.

 You have a professional responsibility to:

• Deal with complaints constructively and honestly;
• Cooperate with any complaints procedure which apply to your practice;
• Ensure that a patient’s complaint does not prejudice the care or treatment you provide or arrange for that patient- it may sometimes be wise to arrange an appropriate referral to another doctor;
• Act immediately to put matters right, if it possible, if a patient under your care has suffered serious harm, through misadventure or for any other reason. You should explain fully to the patient what has happened and the likely short and long-term effects. When appropriate, you should offer an apology. If the patients lacks capacity to understand what has happened, you should provide the explanation to the patient’s parent, guardian, carer or person responsible;
• Cooperate fully with any formal inquiry into the treatment of a patient. You should not withhold relevant information. Similarly, you must assist the justice system to act as expert witnesses. If you are asked to give evidence or act as a witness in litigation or formal proceedings, be honest in all your spoken and written statements. Make clear the limits of your knowledge or competence.
• You must act in your patient’s best interests when making referrals and providing or arranging treatment or care. You must not ask for or accept any inducement, gift or hospitality, which may affect or be seen to affect your judgment. You must not offer such inducements to colleagues.

2.4 When a patient dies

• When a patient dies, you should explain, to the best of your knowledge, the reasons for, and the circumstances of the death to those with parental responsibility, the guardian, carer, patient’s partner or next of kin, unless you know that the patient would have objected.

2.5 When the doctor/patient relationship deteriorates

When the doctor/patient relationship deteriorates, you should:

• Do your best to establish and maintain a relationship of trust with your patient. Rarely, there may be circumstance in which you find it necessary to end a professional relationship with a patient and in such cases you should tell the patient why you have made the decision; and
• Ensure that arrangements are made quickly for the continuing care of the patients, should you terminate the relationship.

2.6 Abuse of your professional position

You must not abuse your patient’s trust. You must not, for example:

• Use your position to establish improper personal relationships with patients or their close relatives;
• Put pressure on your patients to give or lend money or to provide other benefits to you or other people;
• Improperly disclose or misuse confidential information about patients;
• Give patients, or recommend to them, an investigation or treatment which you know is not in their best interests;
• Deliberately withhold appropriate investigation, treatment or referral;
• Allow anyone who is not a registered doctor to carry out tasks, which require the knowledge and skills of a doctor.
• You should disclose any pecuniary interests you may have in giving a referral to a patient.

2.7 Your duty to protect all patients

In order to protect your patients and the public, you should:

• Be vigilant in identifying doctors or other colleagues whose health, conduct, behavior or performance may be a threat to the public;
• Do your best to find out the facts, then, if necessary, notify concerned persons at ADK Hospital. Your comments about colleagues must be honest, and the safety of patients must come first at all times; and
• Report adverse events that reflect on the professional performance or conduct of colleagues.

Standard 3: Relationships with all colleagues

Principles

You must ensure that you enjoy a good relationship with all colleagues in health care teams:

• Through treating colleagues with respect regardless of your personal views;
• By working constructively with all health care professionals in health care teams;
• By ensuring patient treatment is covered during your own absence or unavailability;
• By ensuring appropriate delegation and referral of care of a patient.

3.1 Working with colleagues

• You must always treat your colleagues fairly and without discrimination. You should not allow your views of a colleague’s lifestyle, culture, beliefs, race, color, gender, sexuality, religion or age to prejudice your professional relationship with the colleague.
• You should ensure that students or practitioners under supervision are not abused or harassed.
• You should respect the views of other colleagues even if they differ from your own.
• You must not make any patient doubt the knowledge or skills of colleagues by making unnecessary or unsustainable comments about them;

3.2 Working in teams

• You should work constructively and respect the skills and contribution of all team members;
• You should ensure optimal communication with other members of the health care team;
• You should endeavor to resolve disagreements within the team. If you believe that the decision would harm the patient, tell someone who can take action. If necessary, and as a last resort, take action yourself to protect the patient’s safety or health.

If you are a team leader, you should:

• Take responsibility for ensuring that the team provides care which is safe, effective and efficient;
• Do your best to make sure that the whole team understands the need to provide a polite, responsive and accessible service and to treat patient information as confidential;
• Make sure that colleagues understand their role and responsibilities in the team;
• Make sure that a cohesive approach is taken when there is an error.

3.3 Arranging cover

• You should be satisfied that when you are off duty, suitable arrangements are made for your patient’s medical care. These arrangements are made for your patient’s medical care. These arrangements should include effective handover procedures and clear communication between doctors.

Standard 4: Probity in professional practice

Principles

You must display proper standards of probity in your professional practice.

4.1 Financial interests

• You must be honest in financial and commercial matters relating to your work.
• If you have financial or commercial interests in organizations providing health care, clinics, pharmacies or laboratories, these must not affect the way you prescribe for, treat or refer patients.
• If you have a financial or commercial interest in an organization or hospital to which you plan to refer a patient for treatment or investigation, you must tell the patient about such interest.

4.2 Accepting gifts or other inducements

• You must not ask for or accept any material gifts or loans from companies that sell or market drugs or appliances that would impact negatively on patient care.

4.3 Signing certificates and other documents

Registered medical practitioners have the authority to sign a variety of documents, such as death certificates and sickness certificates, on the assumption that they will only sign statements they believe to be true.

• You must take reasonable steps to verify any statements before you sign a document, and must take responsibility for what you have signed for.
• You must not sign documents which you believe to be false or misleading.

March 31, 2012