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MPS Warns Doctors To Be Cautious When Declaring Patients Fit For Marathons

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MPS is advising doctors to be cautious when completing fitness and health forms for patients competing in sporting and athletic events. This follows enquiries from MPS members about the implications of declaring patients fit and in good health - a registration requirement for the upcoming Rome Marathon (Maratona di Roma, 21 March 2010).
The health form for the Rome Marathon - which must be submitted by competitors from the UK and other non Italian residents - states that the doctor completing the form must declare:
- him or herself fully responsible and acknowledge the consequences for making a false declaration
- that they have undertaken a 'sport physical exam'
- that the competitor is in good health and fit to compete in a 42,195 metre marathon according to current laws.
Dr Pallavi Bradshaw, Medicolegal Adviser at MPS, said: "The health form for the Rome Marathon is unusual because of the information it asks doctors to declare. For example, it asks doctors to perform a 'sport physical exam' with no explanation about what such an exam would entail, and it requires doctors to confirm that they understand 'current laws'. It will come as no surprise to hear that we anticipate that many doctors would have difficulties in complying with the terms of this health declaration form.
"There is no obligation on doctors to complete these forms as they are a non-essential private request falling outside NHS obligations. However, if doctors wish to assist patients by completing these forms, it is important, as with any health declaration form, that they ensure that they feel comfortable and able to meet its requirements."
Doctors who are asked to complete the health form for the Rome Marathon have several options.
- Refuse to complete the form - this could be based on the doctor feeling they don't have a sufficient level of clinical knowledge or expertise to perform a 'sport physical exam'.
- Decline to complete the form as drafted, but use a generic statement about not knowing of any past or current medical reason why the competitor should not be able to participate.
- Even if doctors feel they do have the sufficient knowledge to perform the 'sport physical exam', it might be unwise to declare a patient fit without any other qualifying statement.
Dr Pallavi Bradshaw continues: "It's also important for doctors to be aware of the General Medical Council's guidance, which requires a doctor to do their best to ensure reports they write are not misleading. They should also not undertake assessments beyond their area of clinical competence."
Dr Bradshaw adds: "It comes down to a personal judgement call by doctors as to whether they have the required skills and knowledge to complete these health forms. And if doctors are in doubt, we would encourage them to contact MPS or their MDO".
Medical Protection Society
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