The competence and performance of medical practitioners.
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Biomedical subjects
Publications and source records attributed to I St George.
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The Christchurch Health and Development Study comprises 1,265 children born in 1977. The 23 children who received no diphtheria/pertussis/tetanus (DPT) and polio immunizations had no recorded asthma episodes or consultations for asthma or other allergic illness before age 10 years; in the immunized children, 23.1% had asthma episodes, 22.5% asthma consultations, and 30.0% consultations for other allergic illness. Similar differences were observed at ages 5 and 16 years. These findings do not appear to be due to differential use of health services (although this possibility cannot be excluded) or con-founding by ethnicity, socioeconomic status, parental atopy, or parental smoking.
Until the new Act is in operation, and assuming it has strong and clear sections covering competence, the Medical Council of New Zealand is left with the need to manage unorthodoxy as a form of misconduct unless there is a mental health problem. Charges of misconduct unless there is a mental health problem. Charges of misconduct may arise of there is: harm to patients inadequate information and consent including false representation of the theoretical base of diagnostic method or management, or the training of the doctor, short cuts in the standard methods of diagnosis with the use of unproven and unrecognised methods, treatment programmes that are inappropriate, unjustified, unproven or unsupported by a substantial body of opinion, or that omit consideration if orthodox methods. exploitation in terms of securing patients, financial gain and inadequate aftercare.
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The Cancer Society and the Department of Health invited a working group to make recommendations on screening by mammography. Mammography offers the best opportunity for preventing deaths from breast cancer. Randomised trials suggest that mortality can be reduced by about 30% in women over 50; the value of routine mammography in younger women is still uncertain. Apart from financial costs, the main drawback of mammography is that many women receive unnecessary investigation because of false-positive results. Careful design and monitoring of programmes is essential to ensure that the benefits of screening outweigh the disadvantages. In New Zealand there is a shortage of radiologists, pathologists, and clinicians who are skilled in the specialised techniques required for the screening of asymptomatic women. Decisions about routine screening should be delayed until pilot programmes have been established, with assessment of their effectiveness, economic efficiency, and social acceptability. Recommendations for the design of such programmes are made.
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