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A guide to performance management and support for general practitioners


Last revised: 02 May 2020


Academy of Medical Royal Colleges. Remediation and revalidation: Report and recommendations from the remedial work group of the Academy of Medical Royal Colleges. London: AOMRC, 2009. 

Australian Health Practitioner Regulation Agency. Annual report 2014/15. Your regulatory scheme: Maintaining professional standards for practitioners and managing risk to patients

Cox J, King J, Hutchinson A, McAvoy P, editors. Understanding doctors’ performance. Oxford: Radcliffe Publishing, 2006.

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Health and personal problems

Bismark MM, Spittal MJ, Plueckhahn TM, Studdert DM. Mandatory reports of concerns about the health, performance and conduct of health practitioners. Med J Aust 2014;201(7):399–403. 

Clode D. Emotional health: The conspiracy of silence among medical practitioners. A review of the literature for The Royal Australian College of General Practitioners. Melbourne: RACGP, 2004.

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National Clinical Assessment Service. Handling concerns about practitioners’ health. A guide for managers. London: NCAS, 2011. 

Nielsen HG, Tulinius C. Preventing burnout among general practitioners: Is there a possible route? Educ Prim Care 2009;20(5):353–59.

Rothschild B. Help for the helper. Self-care strategies for managing burnout and stress. New York: Norton, 2006.

Rowe L, Kidd M. Every Doctor. Healthier Doctors = Healthier Patients. CRC Press, Taylor & Francis Group, 2019.

Rowe L, Kidd M. First do no harm. Sydney: McGraw Hill, 2009.

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Shrestha D, Joyce CM. Aspects of work-life balance of Australian general practitioners: Determinants and possible consequences. Aust J Primary Health, 2011;17(1):40–47. 

Yancey JR, McKinnon Jr HD. Reaching out to an impaired physician. Fam Pract Manag, 2010;17(1):27–31.

Attitudes and behaviour (professionalism, boundaries)

Elkin KJ, Spittal MJ, Elkin DJ, Studdert DM. Doctors disciplined for professional misconduct in Australia and New Zealand, 2000–2009. Med J Aust 2011;194:452–56. 

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Hall KH. Sexualization of the doctor-patient relationship: Is it ever ethically permissible? Fam Pract 2001;18(5):511–15. 

National Association of Clinical Tutors. Supporting trainees: A guide for supervisors. Practical advice for educational and clinical supervisors. United Kingdom: NACT, 2018. 

National Clinical Assessment Service. Handling concerns about a practitioner’s behaviour and conduct, 2012

Steinert Y, Cruess RL, Cruess SR, Boudreau JD, Fuks A. Faculty development as an instrument of change. Acad Med 2007;82(11):1057–64. 

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The ageing doctor

Adler RG, Constantinou C, Knowing – or not knowing – when to stop: Cognitive decline in ageing doctors. Med J Aust 2008;189:622–24.

Dellinger EP, Pellegrini CA, Gallagher TH. The aging physician and the medical profession. A review. JAMA Surg 2017;152(10):967–71. doi:10.1001/jamasurg.2017.2342

Eva KW. The aging physician: Changes in cognitive processing and their impact on medical practice. Acad Med 2002;77(10)(Suppl):S1–S6.

Harrison J. Doctors’ health and fitness to practise: Assessment models. Occupational Medicine 2008;58:318–22. 

Harrison J. Doctors’ health and fitness to practise: The need for a bespoke model of assessment. Occupational Medicine 2008;58:323–27. 

Ipsos. Medical practitioners’ ongoing fitness and competence to practice. Report prepared for the Medical Board of Australia. North Sydney, NSW: Ipsos, 2016.

Lillis S, Milligan E. Ageing doctors. Australas J Ageing 2017;36(1):14–18. 

LoboPrabhu SM, Molinari VA, PhD, Hamilton JD, Lomax JW. The aging physician with cognitive impairment: Approaches to oversight, prevention, and remediation. Am J Geriatr Psychiatry 2009;17(6):445–54.

Peisah C, Adler RG, Williams BW. Australian pathways and solutions fro dealing with older impaired doctors: A prevention model. Intern Med J 2007;37:826-831. 

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Bismark MM, Spittal MJ, Gurrin LC, Ward M, Studdert DM. Identification of doctors at risk of recurrent complaints: A national study of healthcare complaints in Australia. BMJ Qual Saf 2013;22:532–540. 

Bismark MM, Spittal MJ, Studdert DM. Prevalence and characteristics of complaint-prone doctors in private practice in Victoria. Med J Aust 2011;195(1):25–28

Morris J, Canaway R, Bismark M. Reducing, identifying and managing vexatious complaints. Summary report of a literature review prepared for the Australian Health Practitioner Regulation Agency. November 2017.

Spittal MJ, Bismark MM, Studdert.DM. Identification of practitioners at high risk of complaints to health profession regulators. BMC Health Services Research 2019;19:380. doi: https://doi.org/10.1186/s12913-019-4214-y

Spittal MJ, Bismark MM, Studdert DM. The PRONE score: An algorithm for predicting doctors’ risks of formal patient complaints using routinely collected administrative data. BMJ Qual Saf 2015;24:360–68. 

Studdert DM, Bismark MM, Mello MM, Singh H, Spittal MJ. Prevalence and characteristics of physicians prone to malpractice claims. N Engl J Med 2016;374:354–62. 

Thomas LA, Milligan E, Tibble H, Too LS, Studdert DM, Spittal MJ, Bismark MM. Health, performance and conduct concerns among older doctors: A retrospective cohort study of notifications received by medical regulators in Australia. J Patient Saf Risk Manag 2018;23(2):54–62. 

Clinical reasoning

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Croskerry P. Achieving quality in clinical decision making: Cognitive strategies and detection of bias. Acad Emerg Med 2002;9(11):1184–204.

Croskerry P. Clinical cognition and diagnostic error: Applications of a dual model of reasoning. Adv Health Sci Educ 2009;14:27–35. 

Groopman J, How doctors think. Boston: Mariner Books, 2008.

Hammond JS, Keeney RL, Raiffa H. The hidden traps in decision making. Harvard Business Review. September–October 1998.

Kurtz CF, Snowden DJ. The new dynamics of strategy: Sense-making in a complex and complicated world. IBM Systems Journal 2003;42(3):462–83. 

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Montgomery K. How doctors think. Clinical judgment and the practice of medicine. Oxford: Oxford University Press, 2006.

Snowden DJ. Complex acts of knowing: Paradox and descriptive self-awareness. Journal of Knowledge Management 2002;6(2):100–11.