Firstly, i understand that doctors in a number of countries these days are required to undergoing continuing medical education (CME) or some form if valudation that each us keeping up to date. I have read about these facts in the various websites of some countrie's medical regulation boards.
The record of each doctor of attendence at approved CME courses each has has to reach a certain minimum number of allocated 'points' in order that the doctor can continue to be re-registered over a certain time interval. There is usually a compulsory requirement that a refresher in resuscitation instruction is undertaken.
Problems i have read about these systems are:
the doctor can just chose any course even though they may be quite knowledgeable about it. And thus not address any deficiences in knowledge or skills. So an opthalmologist might asume they know all about diabetes from their training 10 years ago and choose not to refresh their knowledge.
I get the impression though that medical boards are now requiring their registrants to demonstrate that the CME courses they attend no longer overlap too much in content and skill relearning. Similarly specialty colleges might be doing the same.
And there is also the issue the drug companies often bankroll the costs of many CME activities and they will try possibly to influence the content of the talks on offer. And a drug company can choose not to fund a CME course whuch it sees as irrelevant to its interests or threatening them.
There have been attempts to do inspections of doctors' surgeries, of their practice standards etc under accreditation schemes, in order to give patients some guidance abiut the quality of a particular medical service but this does not automatically ensure the quality of the dictor, nurse and staff within the practice.
Having said this there are many postive feedback reports of a qualitative nature from patients surveys abiut doctors in Oz at least but there has been scathing criticism from the public and doctors about the medical biard of Oz in recent times. And much mire undercurrent if criticism of another HCP regulation body here.
The more thorny question is about what is refered to ( in UK, mainly) as revalidation.
My understanding iof this is that the actual doctor is examined periodically on what the medical board and speciality colleges deem is an appropriate set of knowledge and skills.
As one might imagine, this has met with a great deal of resistance from doctors and the formulation of appropriate examinations has been the source of ridicule and contention.
However arguments ensue that at present the only way that a doctor's knowledge, skills, manner etc can be remediated is when an issue becomes before the country's, States,, county's medical regulation board through a lodged complaint. Complaints can range from minir to allegations of extreme negligence and 'malconduct)
And this raises the question if why should things have to reach this stage before something is done? And can validation processes help to alert to, minimise and prevent disaster in rhe future? And also reduce suffering and large legal and procedural costs?
Many possible reasons exist fir the status quo:
the applicability and effectiveness if current laws about medical regulation;,
the fact that medical boards in some countiry's are still dominated in numbers and thus voting power by doctors ( the UK's GMC i gather is an exception, but I bow to anyone who has more knowledge and understanding of the process in UK) and doctors sometimes have been noted to close ranks of some issues to do with colleagues;
the apparent failure of the validation process to gain more traction ( but again i may be out of date on this)!,;
a natural tendency for some patients to not wish to confront their doctor or report him or her, or who feel the reporting process to a medical board is too overwhelming.
I hope the above provides some background to the problems that patients and authorities face when it comes to the ongoing quality, knowledge, behaviour and skills of doctors, in particular, and HCPs in general.