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(Junk junk) Factors associated with assessment of UK doctors' professionalism


Senior Member
BMJ press release this week.
Haven't looked at the paper so just a thought off the top of my head: they seem to be saying that psychiatrists unfairly get poor assessments from both patients and colleagues. Another interpretation would be that perhaps psychiatrists deserve the poor assessments e.g. they are sloppy?

Caution advised when considering patient and colleague feedback on doctors
(Research: Factors associated with variability in the assessment of UK doctors' professionalism: analysis of survey results)

Official assessments of a doctor's professionalism should be considered carefully before being accepted due to the tendency for some doctors to receive lower scores than others, and the tendency of some groups of patient or colleague assessors to provide lower scores, claims new research published on bmj.com today.

Researchers from the Peninsula College of Medicine and Dentistry in Exeter investigated whether there were any potential patient, colleague and doctor-related sources of bias evident in the assessment of doctors' professionalism.

Doctors' regulator the General Medical Council (GMC) is working on a new system of revalidation for all UK doctors that could be introduced next year as a way of ensuring doctors are fit to continue to practise. This is likely to involve the use of multi-source feedback from patients, peers and supervisors as part of the evidence used to judge a clinician's performance.

The researchers used data from two questionnaires completed by patients and colleagues. A group of 1,065 doctors from 11 different settings, including mostly NHS sites and one independent sector organisation, took part in the study.
They were asked to nominate up to 20 medical and non-medically trained colleagues to take part in an online secure survey about their professionalism, as well as passing on a post-consultation questionnaire to 45 patients each. Collectively, the doctors returned completed questionnaires from 17,031 colleagues and 30,333 patients.

Analysis of the results that allowed for characteristics of the doctor and the patient to be taken into account, showed that doctors were less likely to receive favourable patient feedback if their primary medical degree was from any non-European country.

Several other factors also tended to mean doctors got less positive feedback from patients, such as that they practised as a psychiatrist, the responding patient was not white, and the responding patient reported that they were not seeing their "usual doctor."

From colleagues, there was likely to be less positive feedback if the doctor in question had received their degree from any country other than the UK or South Asia. Other factors that predicted a less favourable review from colleagues included that the doctor was working in a locum capacity, the doctor was working as a GP or psychiatrist, or the colleague did not have daily or weekly professional contact with the doctor.

The researchers say they have identified possible "systematic bias" in the assessment of doctors' professionalism.

They conclude: "Systematic bias may exist in the assessment of doctors' professionalism arising from the characteristics of the assessors giving feedback, and from the personal characteristics of the doctor being assessed. In the absence of a standardised measure of professionalism, doctor's assessment scores from multisource feedback should be interpreted carefully, and, at least initially, be used primarily to help inform doctor's professional development."


Senior Member
Another interpretation would be that perhaps psychiatrists deserve the poor assessments e.g. they are sloppy?

Blasphemy! Wash your mouth out.

Clearly it is everybody else's fault.


Senior Member
Logan, Queensland, Australia
So much psychiatry is guess and test (the treatment). Its not surprising that this is held in low regard, there is a distinct lack of hard science. Of course there are reasons for this - the brain is an extermely complicated organ, more complicated than anything else we are studying - and that includes physics. In my opinion the advances will come from the neuroscience, and psychiatry will just be an applied branch of neuroscience in the future. Of course I am project my own neuroscience bias in saying this, as someone who used to be interested in computational models of mind and mental processes.

Personally if I had an issue, and a doctor said "I guess its this" and "lets experiment with doing this" then I would be unhappy with most doctors especially if they pretended to more knowledge than they had. Hmmm, wait a minute, I do ... ME.

Bye, Alex


Senior Member
I agree with alex - problem of much psychiatry being guesswork (incorrect conclusions being misapplied historically and currently). But I don't altogether see caution needed in colleague feedback. 4 Docs (various specialities) in my own family and they are very chosey about who they see when needed - some simply more informed and better at their jobs than others. Caution exists - but somehow we don't have to be cautious of their caution ! It's a fact - some Docs are better than others. "Bias" it is not.
And the race thing...

Maybe non-white patients rate doctors less well... or maybe doctors treat non-white patients less well.

What a weird study.


Senior Member
Sounds like shrinks are trying to paint themselves as victims. Perhaps they will be filing legislation to receive protected class status, ie it will become illegal to criticize shrinks.


Senior Member
Sounds like shrinks are trying to paint themselves as victims.
Hey? I thought that the psych's made it perfectly clear that everyone was a victim but those with fictitious illness beliefs like ME/CFS who cling to their false beliefs. :rolleyes: