Assuring professional competence in medicine: expectations of the public

A trend toward increased public involvement in assuring professional competence in medicine has resulted as an outgrowth of the consumer movement, the public disenchantment with many traditional institutions, including professions, and broad social acceptance of the concept of health care as a basic human right. Expectations of consumers and the public include a broader definition of professional competence which includes caring and ability to communicate as aspects of curing. Knowledgeable consumers are concerned that inadequate safeguards exist to preclude physicians from practicing beyond their scope of competence and to assure continued competence of a physician over time. While assuring competence is the responsibility of the medical profession, it serves a public function and must be held accountable to public and consumer interests. Consumers should be involved more directly in the process. They can bring valuable judgment to the human questions relating to competence. They can bring a more holistic and humanitarian view to the process. Involvement of consumers, particularly in relation to hearing grievances, would serve to increase public confidence in certifying institutions. They can help assure that public, not merely professionals, interests are served: To assure that consumer representation makes a significant contribution, consumer members of certifying bodies should be provided with adequate orientation, continued training and direct staff assistance to aid in understanding technical issues and evaluating a technical recommendations.