Ethical Consideration for the Senior Physician
CHUMSAK PRUKSAPONG, MD*, SUKHIT PHAOSA VASDI, MD*, SURASAK TANEEPANICHSKUL, MD*, YUEN TANNIRANDORN, MD*, PINIT KULLAVANIJA YA, MD**, AURCHART KARNJANAPITAK, MD***
Affiliation : * Member of Thai Medical Association. •• President of the Royal College of Physicians of Thailand, Secretary General of Medical Council. •• • Member of the Royal College of ENT of Thailand, Deputy Secretary General of Medical Council.
According to Webster's New World Dictionary, competent (adj) means well qualified, capable;
fit. Thus a competent doctor not only has to be qualified but also capable and fit to insure the safety
of any patient seeking his service.
Our medical ancestors taught us long ago that the most important thing to consider before
embarking on medical practice is "First, do no harm" and to ensure that the physician will not do any
harm to his patients he should start with risk prevention.
The cornerstone of risk prevention is the physician's technical and intellectual competence
in order to provide quality assurance for the public.
There are several factors affecting competency and contrary to the old Thai belief that the
"older is wiser" saying may not apply to the medical practice because as the physician becomes older
his physical and mental ability decline. Unfortunately many elderly physicians fail to see their short
coming and continue to practice even though their practice outcome become poorer as measured by
the morbidity, all of which serve no benefit to the public.
Assessing the physician's competency is an important aspect of quality assurance and one of
the method of measuring competency is for the physician to voluntarily participating in the continuing
medical education to ensure that the patients receive the up to date medical knowledge. As far as the
quality assurance is concerned, CME serves only as a minimal requirement to fulfil the competency so
needed in this profession.
Thus it is so unfortunate that many senior Thai physicians oppose the CME scheme designed
by the Thai Medical Council so much so that one of them even took the matter to the administrative
court claiming that the Council violates his constitutional right. One cannot help but wonder what kind
of medical service this elderly physician can deliver without harming the patients since he has no
time for CME.
Keywords : Ethics, Senior Physician
