Revalidation is 'professional Darwinism' that is damaging patient care

Revalidation is a form of 'professional Darwinism' that is threatening the future of relationship-based care by GPs, the conference heard.

Professor Trisha Greenhalgh (Photo: Pete Hill)
Professor Trisha Greenhalgh (Photo: Pete Hill)

Professor Trisha Greenhalgh told the RCGP’s annual conference in Liverpool that the college needed to overturn the ‘unintended consequences’ of revalidation that was driving doctors out of the profession.

‘How many excellent GPs do we know who have thrown in the towel, in some cases five or ten years early, rather than do battle with the system?

‘To retain only those GPs with the inclination and stamina to play the managerialist revalidation game is an alarmingly powerful form of professional Darwinism.’

Professor Greenhalgh, from Barts and the London School of Medicine and Dentistry, warned that relationship based care was also threatened by the shift towards a marketised healthcare system where the sick patient is a customer.

‘In this market model, the doctor-patient relationship is accorded no special status, and good clinical practice is defined largely in terms of information sharing, transparency and an end to medical paternalism.’

‘In reality, most of medical care is not about making decisions. Health problems increasingly involve chronic diseases that require ongoing effort by both patients in the form of self management and professionals in the form of periodical check-ups, management of exacerbations and long-term support.’

Professor Greenhalgh also argued that the over-use of ‘unreal’ situations in medical education, such as simulated patients and standardised scenarios, was a threat to relationship-based care.

‘I know that a structured approach makes both teaching and assessment more consistent and reproducible. But I also know that what honed my own professional virtues was early and prolonged contact with real patients, suffering from real illnesses, real anxieties and real social situations, and shadowing experienced doctors caring for those patients.

‘As a college we owe it to tomorrow’s patients and tomorrow’s doctors to take a stand on the inexorable retreat of medical education from the messy, non-standardisable reality of illness and suffering.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

Close up of a man turning off a light switch

GP's online carbon calculator helps practices cut emissions and save money

A Yorkshire GP has developed an online calculator that is helping practices to reduce...

GP wearing surgical mask speaks to patient in consulting room

General practice recruitment scheme falling short by thousands of staff

A recruitment scheme designed to bring 26,000 extra people into the general practice...

(Photo: Mike Kemp/Getty Images)

Coronavirus: Key guidance GPs need to know about COVID-19

GPonline provides an overview of the key guidance relating to coronavirus, including...

Health and social care secretary Sajid Javid speaking

Sajid Javid writes thank-you letter to 'outstanding' primary care staff

Health and social care secretary Sajid Javid has written a thank-you letter to primary...

Sign pointing to entrance of COVID-19 vaccination hub

Parts of QOF and enhanced services to halt until March to speed COVID booster rollout

NHS chiefs have agreed to suspend parts of the QOF and some enhanced services until...

NHS sign

Barriers to hospital treatment creating 'two-tier' NHS, GPs warn

Long waits for hospital treatment linked to the growing NHS backlog and a rise in...