Medical Regulation

Abstract

The licensing and regulation of physicians is an important topic worldwide and is often tied to discussions in various countries of health care system reform. We conducted a review of current practices for regulating physicians as a key group of health care professionals in eight jurisdictions in Asia and other parts of the world in order to draw implications for the development of future regulatory policies in Hong Kong. Jurisdictions studied included Australia, Canada, China, Malaysia, New Zealand, Singapore, the United Kingdom and the United States. A literature search, supplemented by interviews, was conducted. In analyzing information gathered about global regulatory systems, we used a framework for comparing regulatory typology, developed by the RAND Europe research institute. Our review found that the jurisdictions studied exhibited both similarities and differences in terms of how physicians are regulated and by whom. As a result of our search, we were able to identify 10 key trends in international medical regulation of importance to Hong Kong as it considers reforms to its health care system overall:Changes in medical regulation are seen as a way of improving the quality of patient care.Reform of medical regulation often requires government legislation.The creation of common principles for policies, structures and the organization of regulation between professions is an emerging practice.The involvement of lay people on boards and in inquiries is increasingly common.Medical regulation is moving away from models of self-regulation and toward regulatory models that emphasize partnership between professions and the public, physicians and patients.Health care providers and institutional regulators play complementary roles in medical regulation.Regulation impacts the quality of care — not just the detection and remediation of poor performance.Investigatory and disciplinary functions are increasingly separated and organized independently of each other.Continuous Professional Development (CPD) is compulsory for physicians in many jurisdictions.Overseas medical graduates are admitted into practice in different ways from country to country. These trends are important for regulators in all countries to note as they assess the basic structure and effectiveness of their own medical regulatory systems.