Underperforming doctors: a postal survey of the Northern Deanery.

OBJECTIVES

To discover the perceived size of pool of doctors considered to be underperforming in general practice in the Northern Deanery and to discover whether these perceptions are based on formal assessments.

DESIGN

Postal questionnaire.

SETTING

Area covered by the Northern Deanery.

SUBJECTS

Seven health authority directors of primary care, seven secretaries of local medical committees, and 14 chief officers of community health councils.

RESULTS

The response rate was 100% for directors of primary care and secretaries of local medical committees and, after one reminder, 92% for chief officers of community health councils. Numbers of doctors perceived to be underperforming ranged from none to over 15 in different health authority areas. Main areas for concern were communication skills, clinical skills, and management skills. Patients' representatives were concerned about lack of power of patients and health authorities and doctors' lack of accountability. Health authorities were concerned about lack of power, identification of underperforming doctors, and doctors' professional loyalty. Local medical committees were concerned about the problem of identifying underperformance. A number of methods were used for identification, and there was no common method applied.

CONCLUSIONS

The number of doctors thought to be underperforming was small. Work still needs to be done on developing tools that can be used in everyday practice to enable doctors to confirm for themselves, their colleagues, and their patients that they are providing an adequate level of care.