The guidance that follows describes what is expected of all doctors registered with the GMC. It is your responsibility to be familiar with Good Medical Practice and the explanatory guidance which supports it, and to follow the guidance they contain. You must use your judgement in applying the principles to the various situations you will face as a doctor, whatever field of medicine you work in, and whether or not you routinely see patients. You must be prepared to explain and justify your decisions and actions.
In Good Medical Practice the terms ‘you must’ and ‘you should’ are used in the following ways:
- ‘You must’ is used for an overriding duty or principle.
- ‘You should’ is used when providing an explanation of how you will meet the overriding duty.
- ‘You should’ is also used where the duty or principle will not apply in all situations or circumstances, or where there are factors outside your control that affect whether or how you can comply with the guidance.
To maintain your licence to practise, you must demonstrate, through the revalidation process, that you work in line with the principles and values set out in Good Medical Practice. Serious or persistent failure to follow this guidance will put your registration at risk.
Good Occupational Medical Practice, like Good Medical Practice, is guidance rather than a statutory code: you must relate the general principles to your own practice as an occupational physician.
The GMC advises that the term ‘patient’ in its guidance “also refers to employees, clients, athletes and anyone else whose personal information [a registered medical practitioner] holds or has access to, whether or not caring for them in a traditional therapeutic relationship”. In the guidelines Good Occupational Medical Practice, the term ‘patient’* [1] includes workers who:
- consult the occupational physician either voluntarily or by obligation, e.g. statutory medical examination
- may be affected by the occupational health advice given to employers, or by the health policies an occupational physician advocates
- may use the services for which a doctor has a managerial or professional responsibility.
Reference is made throughout (as in the GMC’s guidelines) to prescribing for and treating patients. Occupational physicians seldom prescribe drugs therapeutically, but do sometimes prescribe immunisations, travel medicines, post-exposure prophylaxis, and specific occupational interventions; they may also, provide emergency care, or advise patients on exposure avoidance measures and other actions that contribute to the overall medical management of an illness. In all of these situations, due care is required, as it would be for other physicians, and the standards which are described should apply.
* Many occupational physicians use the term ‘client’, ’employee’, or ‘worker’, rather than ‘patient’, to emphasise a relationship that is frequently non-therapeutic and with the intent of keeping workers healthy.