NZREX Communication and Professionalism 2 — Questions and Answers
Question 1: In NZ medical practice, what is the doctor's obligation when they make a clinical error?
- Disclose the error to the patient (open disclosure), report it through the incident reporting system, and participate in a review to prevent recurrence (Correct answer)
- Hide the error to avoid legal consequences
- Only disclose if the error caused visible harm
- Report it anonymously and avoid discussing it with the patient
Correct answer: Disclose the error to the patient (open disclosure), report it through the incident reporting system, and participate in a review to prevent recurrence
NZ medical practice requires open disclosure of clinical errors to the patient/whānau, reporting through the incident management system, and participation in reviews aimed at learning and preventing recurrence. NZ's ACC system removes the adversarial litigation element.
Question 2: How should a doctor in NZ manage a request from police for patient medical information?
- Patient information is confidential — only release information with patient consent, a valid court order, or if required by specific legislation (e.g., blood alcohol in drink-driving cases) (Correct answer)
- Provide all requested information immediately
- Refuse all police requests regardless of circumstances
- Release information only if the patient is present
Correct answer: Patient information is confidential — only release information with patient consent, a valid court order, or if required by specific legislation (e.g., blood alcohol in drink-driving cases)
In NZ, patient medical information is confidential under the Privacy Act 2020 and Health Information Privacy Code. Information should only be released to police with patient consent, a valid court order or search warrant, or where specific legislation requires disclosure.
Question 3: In the NZREX clinical exam, what is expected regarding cultural safety in patient interactions?
- Demonstrate awareness of cultural differences, ask patients about their cultural needs, avoid assumptions, and adapt communication style accordingly (Correct answer)
- Treat all patients identically regardless of cultural background
- Only demonstrate cultural safety with Māori patients
- Cultural safety is not assessed in the NZREX
Correct answer: Demonstrate awareness of cultural differences, ask patients about their cultural needs, avoid assumptions, and adapt communication style accordingly
The NZREX assesses candidates' cultural safety by expecting them to demonstrate awareness of cultural differences, ask about and respect cultural needs and preferences, avoid stereotyping, and adapt their communication style to be appropriate for each patient.
Question 4: In NZ, what is the correct approach when a patient asks you to provide a medical certificate for time off work?
- Assess the patient clinically, document your findings, and provide a certificate that is honest and accurate — you must believe the patient has a genuine medical reason (Correct answer)
- Always provide a certificate if the patient asks, regardless of clinical assessment
- Refuse all medical certificate requests as they are not a medical responsibility
- Only provide certificates for conditions lasting more than one week
Correct answer: Assess the patient clinically, document your findings, and provide a certificate that is honest and accurate — you must believe the patient has a genuine medical reason
NZ doctors should clinically assess the patient, document their findings, and issue a medical certificate only if they genuinely believe the patient has a medical condition justifying time off work. The certificate should be honest, accurate, and describe the functional impact.
Question 5: What is the NZ approach to managing disagreements between healthcare team members regarding patient care?
- Discuss concerns openly and respectfully, use evidence to support clinical positions, escalate through appropriate channels if unresolved, and always prioritise patient safety (Correct answer)
- The most senior person's opinion always prevails without discussion
- Avoid raising disagreements to maintain team harmony
- Report all disagreements to the Medical Council
Correct answer: Discuss concerns openly and respectfully, use evidence to support clinical positions, escalate through appropriate channels if unresolved, and always prioritise patient safety
NZ healthcare promotes a culture where all team members can raise concerns about patient care, discuss them openly and respectfully using evidence, and escalate through appropriate channels if needed. Patient safety always takes priority over hierarchy or interpersonal dynamics.
Question 6: In NZ, what professional standards apply to a doctor's use of social media?
- Doctors must maintain confidentiality, professional boundaries, and should not post identifiable patient information or bring the profession into disrepute (Correct answer)
- There are no professional standards regarding social media use
- Doctors may share patient cases publicly if they remove the patient's name
- Social media use is completely prohibited for doctors in NZ
Correct answer: Doctors must maintain confidentiality, professional boundaries, and should not post identifiable patient information or bring the profession into disrepute
The MCNZ requires doctors to maintain patient confidentiality on social media (no identifiable information), uphold professional boundaries (avoid patient friend requests), and not post content that could bring the medical profession into disrepute or undermine public trust.
NZREX Communication and Professionalism 2
In NZ medical practice, what is the doctor's obligation when they make a clinical error?