Medico-legal issues to consider before pursuing a portfolio medical career
Doctors need to consider a variety of ethical and legal aspects when developing their portfolio career, says Dr Ellie Mein, a medico-legal adviser at the Medical Defence Union (MDU).
Many doctors are drawn to the idea of a portfolio career because they are seeking an improved work life balance, variety in their professional life or to generate additional income. Career flexibility within medicine is also important for both attracting and retaining clinicians, but when embarking on a varied career path, it’s important for doctors to consider some of the ethical and legal aspects.
Managing your time
One reason doctors develop a portfolio career is because they want a better work-life balance, but it is possible that juggling more than one role will have the opposite effect. Consider any additional administration required for any new role, or the time taken to complete more than one set of continuing professional development (CPD) requirements.
Competency in all roles
Maintaining competence in all roles may present logistical challenges too, as the number of roles increases. The General Medical Council (GMC) is clear that doctors must be competent in all aspects of their work and keep up to date with guidelines and developments that affect their work.
Restrictions of current role
Check if any restrictions or contractual terms apply to holding additional roles or providing certain medical services. For example, junior doctors need to be aware of the approved practice setting requirements. If you are on a UK training programme, any work outside of this must be discussed with your educational supervisor.
Indemnity and insurance
It is important to keep your medical defence organisation updated on the extent and scope of your current medical practice so that you can be sure that you have appropriate indemnity.
As the GMC’s Good Medical Practice states,: “You must make sure that you have appropriate and adequate insurance or indemnity that covers the full scope of your practice. You should keep your level of cover under regular review.”
In addition, doctors with a portfolio career may need to register with other regulatory bodies. For example, they must register with the Care Quality Commission (CQC) if they intend to provide a regulated health or care service, and seek approval from the Medicines and Healthcare products Regulatory Agency (MHRA) for marketing a product. Also check whether you need insurance for non-clinical matters, such as public liability insurance or employers liability.
Guarding your professional reputation
Healthcare regulators’ codes of conduct are not restricted to your professional workplace and extend to any other work you do and even certain conduct in your personal life. Ensure that you don’t inadvertently fall foul of legal and regulatory requirements if you are developing alternative income streams.
If you are promoting your services on social media, for example, GMC guidance says you must be open and honest about “any interests you have that may influence (or could be seen to influence) the recommendations you make.” The guidance goes on to clarify that, “you must also comply with relevant law, guidance and regulatory codes including those from the Committee of Advertising Practice, the Advertising Standards Authority and the Competition and Markets Authority.”
Another area to pay attention to is the development of medical content or technology. If you are involved with this, ensure, you do not stray into territory that risks copyright infringement or intellectual property theft.
These examples are not exhaustive but illustrate that when expanding your career portfolio there are many factors to consider.
In summary, when forging a portfolio career, you will need to act with honesty and professionalism, ensure you have appropriate indemnity, and work within your sphere of competence and the relevant regulatory and legal frameworks.
