Hoe zwaar wegen richtlijnen in oordeel tuchtcollege?

Objective

To examine how often disciplinary complaints against physicians are upheld explicitly on the grounds of deviation from clinical practice guidelines.

Design

Retrospective document analysis of publicly available medical disciplinary rulings in the Netherlands between January 1, 2019, and December 31, 2023.

Methods

We analysed rulings from the official Dutch disciplinary law database (tuchtrecht.nl). All upheld complaints were reviewed to determine whether the disciplinary board explicitly cited deviation from a clinical guideline as part of its reasoning. We also collected data on the type of sanction, medical specialty, and the guideline involved.

Results

Of the 1,799 rulings, 514 complaints were upheld. In only six cases (1%), deviation from a clinical guideline was explicitly mentioned as a reason for the decision. In all six cases, the deviation was neither justified nor documented in the patient’s medical record.

Conclusion

Explicit citation of deviation from clinical practice guidelines as a reason for upholding disciplinary complaints is rare. These findings highlight the importance of proper documentation and may help reassure physicians about the professional discretion available when deviating from guidelines with well-substantiated reasoning.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.