What’s in a name? Confusion remains over titles in the health sector

What’s in a name? Quite a lot it turns out. Earlier this month, at a fitness to practise hearing, it was reported that consultant radiologist Dr Dawar Siddiqi got his job at Bantry General Hospital on the basis of his CV which said he was a consultant.

Siddiqi has a basic medical degree and is listed on the Medical Council’s general register, like several doctors who are also being described as consultants in some private hospitals and clinics.

The Royal College of Physicians of Ireland says that it takes about 15 years to become a specialist, usually described as a consultant. Since 2009, doctors appointed to public hospitals as consultants must be on the specialist division of the register. Those who train to become GPs after completing their basic medical degree are also listed on the register’s specialist division.

The council says doctors on the register “cannot purport to be a specialist and to falsely do so is an offence that should be notified to the Medical Council”.

However, it says doctors on the register are entitled to practise medicine independently according to the needs of their employer and that it’s up to employers to define roles and ensure staff are suitably qualified to meet the specific requirements of their role. The term “consultant” is not one which the council uses.

Not protected

The Irish Hospital Consultants’ Association says a consultant is a registered medical practitioner consulted by other registered medical practitioners.

The council says the term “general practitioner” would be how it would expect a doctor who has completed general practice training to describe him or herself, although it said the term “general practitioner” is not protected in law.

The same confusion with titles occurs in other areas of the health sector. In 110 countries worldwide, the title “physiotherapist” is synonymous with “physical therapist” except in Ireland, according to Ruaidhri O’Connor, chief executive officer of the Irish Society of Chartered Physiotherapists (ISCP).

His organisation is seeking to have the two terms protected for use only by physiotherapists, claiming the lack of such definitions is contributing to confusion– in a survey carried out earlier this year more than 80 per cent of the public didn’t know the difference between a physical therapist and a chartered physiotherapist.

Parents reading a US website might note, for example, that physical therapy is recommended for their child’s condition.

But O’Connor points out that in Ireland the training for a physiotherapist includes musculoskeletal, cardio-respiratory and neurological study during a four-year degree course with 1,000 hours of supervised clinical placements. People currently trained as physical therapists in Ireland are not educated to this level, according to the ISCP.

Online diploma

Currently, for just €39 one can buy a diet and metabolism specialist online diploma including an “option to open a diet specialist nutrition clinic upon completion”.

However, from next October the term “dietitian” will become a protected term, according to Louise Reynolds, spokeswoman for the Irish Nutrition and Dietetic Institute.

“If you’re getting one-to-one advice on diet, that should be coming only from a dietitian,” says Reynolds. There are good courses, including some university courses, in human nutrition but they don’t qualify those trained in them to see patients working in a clinical setting, she says.

Fifteen professions are covered so far under the Health and Social Care Professionals Act 2005 (as amended) including social workers, dietitians, occupational therapists, radiographers and radiation therapists, speech and language therapists, psychologists, podiatrists and orthoptists.

Registers will open shortly for physiotherapists and social care workers, and optometrists and dispensing opticians will be included in future.

“We are aware that many other professions would value being regulated by Coru, however, any decisions regarding professions to be regulated is a matter for the Minister for Health and his department, who will also decide which regulator is most appropriate to the relevant profession,” says Coru, the regulator for health and social care professions.

An area that hasn’t come under Coru’s remit yet is that of counsellors and psychotherapists, though the Department of Health is considering extending that remit to cover this and other areas.

Gerry Raleigh, director of the HSE’s national office for suicide prevention (NOSP), says he is anxious to see this area regulated. Although many counsellors provide a very good service, there are still people presenting as such “and we’re not sure how well qualified they are”, he says.

The NOSP funds about 30 organisations offering counselling but anecdotally there appear to be hundreds working in the area of suicide prevention.