Respect for Colleague

Physicians should demonstrate mutual respect and maintain clear lines of communication with colleagues, particularly those with whom they share the care of a patient.

Delegation, Referral and Handover

Physicians should take care to ensure that the colleagues, to whom they delegate, refer or handover the care of their patient is suitably qualified and competent to provide the care necessary.

The physician should make available sufficient information to their colleague to facilitate uninterrupted appropriate care of the patient.

If a patient comes to a physician with/without a referral, the physician should ask permission to share their findings with the patient’s primary care provider to ensure continuity of care. Similarly, any investigations, results, or treatment should be shared preferably in writing, with the physician.

All patients are entitled to care that meets their individual needs; therefore every patient has the right to ask for a second opinion, without fear of recrimination. If a third party (e.g. insurance company) seeks a second opinion on behalf of a patient, then the patient’s permission must be sought prior to disclosure of information.

When a team of doctors is charged with the care of a patient, each team member is individually accountable for that patient.

Effective communication within the team is essential to avoid error and poor management. Medical team members should therefore be able to identify errors, disclose and discuss them without fear of penalty; and engage in audit and peer review to improve the delivery of health care by the team.

The role of each team member must be defined and the team leader determines the function and responsibilities of the other members of the team. The patient must be made aware of the person who has overall accountability for organizing care.

Delegation of duties to junior team members does not excuse a senior doctor from the overall responsibility of care: The senior doctor is still accountable for the decision to delegate and the overall management of the patient.

If a physician finds a colleague to be impaired, incompetent or unethical, the physician should approach the situation in the following three steps;

• advise the colleague that their behaviour is unsafe or unethical and discuss options regarding seeking help;



• if the colleague does not take any measures to resolve the problem then the physician should inform the colleague’s supervisor or immediate senior who will take further action as necessary. If this action is unsuccessful or not feasible then the Medical Board of Trinidad and Tobago should be informed. The likelihood of patients being harmed is of paramount importance and takes precedence over the approach used.


• If a patient is in immediate danger then the physician should also attempt to minimise the harm the patient may experience.

If the Medical Council finds, after due enquiry, that a medical practitioner is suffering from a physical or mental condition that might constitute a danger to the public or patients if he continues to practise, the Council may suspend the member from practising until such time as in the opinion of the Council such member is able to resume practice