The right skills
Offering your skills at sporting or charity events can be an interesting addition to your regular clinical work and can add variety to your practice. But before providing medical assistance in situations like these, even on a voluntary basis, you should make sure you have appropriate qualifications, skills, experience, equipment and support. The GMC's Good medical practice guidance (2013) states 'you must recognise and work within the limits of your competence'.
The types of medical problems an event doctor faces can range from relatively minor cuts and bruises to acute traumatic injury of a participant, concussion, spinal injury, facial injuries or cardiac arrest. At smaller events, you may also be asked to treat crowd members who are taken ill. If you are unsure what you may need, check with the event organiser or relevant sporting organisation.
Medical graduates who are new to full registration and doctors restoring to the medical register after a prolonged break are subject to the Approved Practice Settings (APS) scheme. Those under the APS scheme must be connected to a 'designated body' in order to practise in the UK. If you are APS connected, you may volunteer to provide medical assistance at events as long as you:
- have the approval of your educational supervisor to do so
- maintain your connection with your designated body
- comply with any reporting requirements as set out by your responsible officer or training body.
In line with GMC guidance, you'll need to ensure that your skills and experience are appropriate for the task ahead. You will need to check you comply with relevant guidelines on equipment and support where available, and it may help to familiarise yourself with local health services, in particular the ambulance service, in the event that a seriously injured patient needs to be transferred to hospital.
As stated in paragraph 63 of Good medical practice, you have an ethical duty and a statutory requirement to ensure you have adequate indemnity or insurance before you offer your services, 'so that your patients will not be disadvantaged if they make a claim about the clinical care you have provided in the UK.'
The MDU can offer indemnity to doctors who choose to provide care at amateur sporting events. Some professional sports organisations or organising bodies provide indemnity for doctors acting in a professional capacity, and you would need to check this before the event. If the organisation can't provide you with indemnity, please contact us to check whether your current membership will indemnify you for this. This is equally important whether you are paid or planning to attend voluntarily.
Acting as an event doctor is quite separate from engaging in a Good Samaritan act, where a doctor attends an event in a non-professional capacity and is called upon to provide medical care in an emergency. GMC guidance makes it clear you have an ethical duty to give what assistance you can in the circumstances, saying, 'You must offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, your competence, and the availability of other options for care. You must provide what assistance you can, working within your competence unless there is no reasonable alternative'.
The MDU provides medical indemnity for Good Samaritan acts to its members worldwide, but thankfully the risk to doctors of being sued after they have helped in an emergency is very low.
If there is a medical problem during the event, your ethical responsibilities, such as the need to obtain consent and to maintain confidentiality, remain the same as in any other aspect of your medical practice. Consent can be written, verbal or implied and you have a duty to keep all information about patients confidential unless you have their consent to disclose that information. You should also keep detailed notes of any incidents and the medical care you provide.
If members have concerns about the work they are asked to or want to undertake they can contact our advice line for guidance. We also ask doctors to keep our membership department up to date with the work they undertake in order to ensure that they are appropriately indemnified.