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Table 3 Disciplinary procedures

From: Regulatory tasks of national medical associations - international comparison and the Israeli case

Legislation

Responsibility

NMA involvement

Maximum sanction

Minimum sanction

Ethical breaches

GERMANY

Two possible disciplinary procedures: one under the professional code (Berufsrechtliches Verfahren) and the other under federal licensing law

Both the Government and the NMA

In case of an alleged breach of the professional code of conduct, the State Chamber may undertake procedures under professional law.

The Chamber of Physicians may issue a statement of unreliability or unworthiness, often resulting in competent state health authorities revoking the license to practice.

Warning

In case of an alleged breach of the professional code of conduct, the State Chamber may undertake procedures under the professional law.

ISRAEL

The Physicians’ Ordinance

Government

The IMA is not responsible for disciplinary procedures; however they do issue certain sanctions for ethical breaches.

The Ministry of Health may suspend or cancel a physician’s license.

Warning

The IMA may issue sanctions for breaches of the IMA Ethical Code.

NETHERLANDS

The BIG Act

Government

Disciplinary proceedings are performed by independent judicial courts. These courts (tuchtcolleges) consist of two lawyers and three members of the medical profession; the latter are nominated by the KNMG.

Deletion from the BIG registry and withdrawal of the basic medical registration.

Monetary fine

In the case of a breach of the KNMG code of conduct physicians may report their colleagues to the KNMG Council for Disciplinary Proceedings

UK

The Medical Act (1983)

GMC

The BMA is not involved in instituting disciplinary proceedings for physicians, although they may represent them.

Suspension or removal from the medical register.

Warning

The GMC may issue warnings to physicians when their practice is not in-keeping with the GMC’s guidance on Good Medical Practice.

US

State Medical Practice Acts

State medical board

When disciplinary sanctions are issued, State Medical Boards are required to report these sanctions to a wide range of bodies, including the AMA.

Disciplinary proceedings differ across states, however in many cases State Medical Boards may revoke or restore licenses.

Probation or license restrictions

Medical societies may discipline members for ethical standard violations by excluding them from the society. They must report any breaches to the relevant government body or state board of medical examiners