30th October 2023

The Social Role of Doctors

The consensus statement on the role of the doctor

The consensus statement on the doctor’s role was initially drawn up in 2008, as agreed by leaders in the medical profession. This was then updated in 2013, taking into account patients’ views from focus groups, the NHS constitution, Good Medical Practice 2013, and the original signatory organisations.

This statement identified the following as key aspects of the role of the doctor:

To introduce themselves clearly to help build and maintain trusting relationships with patients and colleagues.
To listen and assess patients’ needs, considering their social circumstances.
To apply up-to-date knowledge and skills to find the best available diagnosis or understanding of a patient’s problem or identify the next steps to reach this outcome.
Explain and discuss the risks, benefits and uncertainties of investigations and treatments such that is understandable to patients.
Identify, explain and advise on relevant treatment options or preventative measures.
Help patients to understand their condition and what they might expect.
Support patients to be autonomous and make decisions about their own healthcare.

‘I swear by Apollo the Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgement, this oath and this indenture.’ – The Hippocratic oath

Many medical school graduates take an oath at their graduation ceremonies, some of which are in part related to the Hippocratic oath. The Hippocratic oath has, in the past, offered some guidance for how doctors practise. Today, it seems outdated and does not address many relevant issues for modern medical practice. The World Medical Association (WMA) revised the Hippocratic oath and published the Declaration of Geneva in 1948.

‘I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing, or any other factor to intervene between my duty and my patient.’ – The Declaration of Geneva

GMC Good Medical Practice

The GMC sets out guidance in ‘Good Medical Practice’ that states that doctors must ensure their practice meets their standards in four domains:

Knowledge, skills and performance – Doctors must keep their professional knowledge and skills up-to-date; doctors must recognise and work within the limits of their competence.

Safety and quality – Protect and promote the health of patients and the public.

Communication, partnership and teamwork – Respect confidentiality; work in partnership with patients; work with colleagues to best serve patients.

Maintaining trust – Be honest, open and act with integrity; never discriminate against patients or colleagues; never abuse patients’ or the public’s trust in the profession.

The GMC ‘Outcomes for graduates’, 2018

The GMC offers a more modern idea of the role and standards for a newly qualified doctor, as detailed in ‘Outcomes for graduates’. These outcomes are categorised into 3 sub-sections:

Outcomes 1 – Professional values and behaviours – Professional and ethical responsibilities; legal responsibilities; patient safety and quality improvement; dealing with complexity and uncertainty; safeguarding vulnerable patients; leadership and teamwork.
Outcomes 2 – Professional skills – Communication and interpersonal skills; diagnosis and medical management; prescribing medications safely; using information effectively and safely.
Outcomes 3 – Professional knowledge – The health service and healthcare systems in the four countries; applying biomedical scientific principles; psychological principles; social science principles; health promotion and illness prevention; clinical research and scholarship.

Fundamentally, the roles and outcomes for a doctor, as outlined in different definitions, overlap significantly with themes and qualities. These include maintaining up-to-date knowledge and clinical skills, maintaining professional relationships, honesty and integrity, and promoting patient safety.

The role of the psychiatrist

The Royal College has some guidance for patients about ‘What to expect of your psychiatrist in the UK’. This includes the expectation that psychiatrists will use the biopsychosocial model of understanding, assess mental state, diagnose, and use a range of treatments to help a person recover. When compared with the GMC guidance and consensus statement, the most significant difference that is listed in the description of a doctor vs a psychiatrist (as by the Royal College) is the emphasis on the biopsychosocial model of understanding.