PATIENTS WILL be able to refer themselves to medical specialists without having to be assessed first by a general practitioner, according to radical changes to be considered by the incoming Medical Council.
As part of a major review of its ethical guide for doctors, the ethics committee of the outgoing Medical Council, which meets for the last time today, has completed work on new ground rules governing how doctors are permitted to practise. The Irish Times understands the proposals include a substantial relaxation in restrictions on how doctors advertise.
Under the existing Guide to Ethical Conduct and Behaviour, doctors setting up in practice are restricted to placing a notice "not exceeding 100mm in any direction", in the national or local press. Section D of the guide expressly forbids the use of display advertising by doctors.
According to informed sources, the new rules will allow unrestricted advertising in directories such as the Golden Pages. Guidelines on internet advertising will be relaxed and doctors will be encouraged to advertise specific services they can offer patients. For example, an orthopaedic surgeon will be allowed state that he offers expertise in hip or knee replacements.
Exaggerated claims about an individual practitioner's abilities will not be permitted and the new rules will specifically crack down on doctors who advertise unproven "wonder cures" for cancer and other serious medical conditions.
More liberal advertising will also encourage competition. Representatives from the Medical Council met the Competition Authority recently when it is understood the need for new Medical Council rules to encourage competition was discussed.
Some members of the outgoing council are known to have resisted a number of the more radical proposals put forward by the chair of the Ethics Committee, Dr Deirdre Madden. However, as Dr Madden, a law lecturer in UCC, has been appointed to the new Medical Council by Minister for Health Mary Harney, it is expected a new ethical guide will be approved early in its term.
Restrictions in how doctors deal with the media will also be lifted. The current ethical guide states: "In adjudicating on complaints concerning doctors in the media, the Medical Council will consider whether the benefit to the doctor has been greater than to the public and whether there has been an element of self-advertisement or a claim of possession of special skills, either of which could be interpreted as canvassing for patients".
Historically, most complaints to the Medical Council about advertising and media issues have been made by doctors rather than by patients. However, by permitting patients to refer themselves directly to specialists - as is the case in the US - the Medical Council can expect some resistance from general practitioners who value their role as gatekeepers in the health system.