As a result of recent claims in the press, the Barbados Medical Council thinks it is desirable to clarify the position of persons calling themselves ???Specialists??? in medical practice in Barbados.
Prior to the enactment of the Medical Profession Act in 2011, the Medical Profession was governed by the Medical Registration Act, Cap 371, where all doctors were registered as ???Medical Practitioners??? with the qualifications they had obtained to become such. The Medical Registration Act called for additional qualifications approved by the Council to be entered in the register.
Howver, there was no register of specialists. Reference to a ???specialist??? did not appear in the Act itself but did appear in the Regulations to the Act under the section labelled ???Professional Conduct and General Fitness to Practise Medicine???. In those Regulations, it was stated that it was an offence for a Medical Practitioner to ???hold out to the public that he is a specialist or is specially qualified in any particular branch of medicine unless he has taken special training, and such special qualification has been registered in accordance with the Act.???
Prior to the new Act in 2011 when complaints were made, the Council limited itself to responding to queries where a practitioner claimed to have qualifications that they did not hold. The public had no place to check whether practitioners had ???specialist??? qualifications and relied entirely on the signage used by practitioners and other forms of promotion.
The new Act provides for a register of specialists to be available to the public. The register was first published in 2013. Entry on the register is based on proof of training and qualification; and in a ???grandfather??? provision which had to be satisfied on a date ???not later than December 31st, 2012???.
The Council, in order to assess the attainment of the ???skill and competence in the specialty???, has relied on the assessment of the practitioner???s peers in the jurisdiction where they state to have ???been engaged in practice in a specialty recognised by the Council for a period of not less than 10 years, and had the requisite experience, skill and competence in the specialty???. Professional competence may also be assessed on the professional and ethical conduct of a practitioner, or their conviction for criminal offences.
Neither the old or new Acts provide any schedule of procedures that a medical practitioner or specialist can or cannot do. In fact, an analysis will show that there would be considerable overlap in many categories of practice. Unfortunately, disputes about such boundaries can only be resolved in a court of law, usually after a patient has been harmed. The provision of the specialist register, therefore, informs the public about those who have satisfied the requirements in law for being a specialist: It ??does not proscribe for the public what procedures they may agree to with any particular practitioner.??
It must also be stated that the Medical Council has no schedule of fees or any control over what a particular practitioner charges for a service provided. This applies to individual or third party payments.??When a person holds himself or herself out to be a ???medical practitioner??? when they are not so registered, the Medical Council has no jurisdiction and this is reported to the police.
When a medical practitioner holds himself or herself out to be a specialist when they are not registered as such, the Council has jurisdiction to discipline the medical practitioner. The disciplinary measures that the Council has, ranges from requiring the practitioner to cease making the claim, up to the revocation of his or her licence as a medical practitioner.