Engagement, not personal characteristics, was associated with the seriousness of regulatory adjudication decisions about physicians: a cross-sectional study

Abstract

BackgroundOutcomes of processes questioning a physician’s ability to practise —e.g. disciplinary or regulatory— may strongly impact their career and provided care. However, it is unclear what factors relate systematically to such outcomes.MethodsIn this cross-sectional study, we investigate this via multivariate, step-wise, statistical modelling of all 1049 physicians referred for regulatory adjudication at the UK medical tribunal, from June 2012 to May 2017, within a population of 310,659. In order of increasing seriousness, outcomes were: no impairment (of ability to practise), impairment, suspension (of right to practise), or erasure (its loss). This gave adjusted odds ratios (OR) for: age, race, sex, whether physicians first qualified domestically or internationally, area of practice (e.g. GP, specialist), source of initial referral, allegation type, whether physicians attended their outcome hearing, and whether they were legally represented for it.ResultsThere was no systematic association between the seriousness of outcomes and the age, race, sex, domestic/international qualification, or the area of practice of physicians (ORs p≥0.05), except for specialists who tended to receive outcomes milder than suspension or erasure. Crucially, an apparent relationship of outcomes to age (Kruskal-Wallis, p=0.009) or domestic/international qualification (χ2,p=0.014) disappeared once controlling for hearing attendance (ORs p≥0.05). Both non-attendance and lack of legal representation were consistently related to more serious outcomes (ORs [95% confidence intervals], 5.28 [3.89, 7.18] and 1.87 [1.34, 2.60], respectively, p<0.001).ConclusionsAll else equal, personal characteristics or first qualification place were unrelated to the seriousness of regulatory outcomes in the UK. Instead, engagement (attendance and legal representation), allegation type, and referral source were importantly associated to outcomes. All this may generalize to other countries and professions.

Character failings in the surgeon fallen from grace: a thematic analysis of disciplinary hearings against surgeons 2016–2020

“…that employers and healthcare providers were more likely to refer doctors who obtained their primary medical qualification outside the UK and those who were from a black and minority ethnic (BME) background 19 . It is some small comfort that a follow-up study demonstrated that the seriousness of regulatory outcomes was unrelated to these characteristics, but rather to engagement with the process (attendance and legal representation), prompting the GMC to redefine support mechanisms for doctors facing tribunal proceedings 20 .…”

Factors associated with severity of sanctions among pharmacy professionals facing disciplinary proceedings

“…Given the similarities to both national and international disciplinary process of the GPhC's disciplinary machinery, [6,[29][30][31][32][33][34] this may generalize to other professions across jurisdictions.…”

Long noncoding RNA Gm44593 attenuates oxidative stress from age-related hearing loss by regulating miR-29b/WNK1

“…Age-related hearing loss (AHL), characterized by the irreversible loss of cochlear hair cells [ 1 ], spiral ganglion neurons (SGNs) and stria vascularis cells (SVs), is the most common sensory disorder in old people [ 2 ], influencing the life quality of people aged 65 years or over [ 3 ]. AHL increases the risk of depression, cognitive impairment and dementia in aged adults [ 4 , 5 ].…”