|(From left, Nancy Whitmore, CEO of College of Physicians and Surgeons of Ontario (CPSO), Lisa Brownstone, CPSO’s chief legal officer, Humayun Chaudhry, secretary of International Association for Medical Regulatory Authorities (IAMRA), and Ahn Deok-seon, director of Korean Medical Association’s Research Institute for Healthcare Policy, attend an academic forum in Seoul, last Friday.
A medical self-regulatory authority should aim to protect citizens, not doctors, and citizens must participate in such a body, an international expert said.
Humayun Chaudhry, chair and secretary of the International Association for Medical Regulatory Authorities (IAMRA), made this and other points at the International Symposium on Self-Regulation, held as part of the Korean Medical Association’s academic forum in Seoul, Friday.
“An autonomous medical body is responsible for setting standards for medical practices and for guiding and observing physicians' compliance with the standards. If doctors do not abide by these rules, it can decide on when and how to punish them,” Chaudhry said.
He took an example of the United States, where citizens participate in medical regulatory authorities in all states. In California, eight members out of 16-member boardroom are citizens who play essential roles with voting rights, he explained.
“What’s important is when a reasonable complaint is raised, doctors and the person who raised the issue work together to solve the problem. A self-regulatory authority aims to protect citizens, not doctors,” he added.
The participation of citizens is also common in New Zealand, South Africa, and the United Kingdom, Chaudhry went on to say.
He emphasized that to operate self-regulation properly, physicians, the government, and citizens must build trust.
Nancy Whitmore, CEO of the College of Physicians and Surgeons of Ontario (CPSO) in Canada, said a medical self-regulatory authority should watch out for excessive intervention and regulation when an incident occurs.
Also, the regulation should be within the right principles such as balance, consistency, objectivity, transparency, responsibility and agility, she said.
“The right regulation is to focus on the problem and minimize side effects. A regulatory institution should be open and make rules simple and user-friendly,” she said. “A regulatory body should be able to justify its decisions and be subject to public verification. It also has to have the agility to look ahead, predict change and adapt.”
Chaudhry noted that in the U.S., it was extremely rare to hold a doctor accountable for criminal liability for medical malpractice because a regulatory body imposes regulation autonomously.
“It is rare to charge against a doctor in a criminal case in the U.S. There are few cases where doctors get sued for criminal charges,” he said. “This is because a licensing body regulates doctors autonomously. In a serious case or if public health is put to risk, a doctor can be charged criminally. But there are few of them.”
Lisa Brownstone, chief legal officer of CPSO, said it was the same in Canada.
“I heard some cases in Korea, which was quite surprising. There is no such case in Canada,” Brownstone said. “Even if a patient dies and there was a mishap, a doctor does not face a criminal charge unless death was intentional. The intention is the key.”
Whitmore said establishing a self-regulatory authority would protect doctors from getting criminal penalties in medical malpractices.
“The strongest merit of a self-regulatory body is that there will be a standard that doctors could follow. If a doctor had a good intention and did everything he or she could do, the body can protect the doctor even if a patient died,” she added.
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