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[Removal from the Dutch healthcare professionals register: considerations taken into account by the disciplinary tribunal from 2006 to 2011].

OBJECTIVE
Investigation into the considerations taken into account by the central and regional disciplinary tribunals for the health service (CTG and RTG) in cases where a doctor was permanently removed from the national professional register.


DESIGN
Retrospective study of jurisprudence and literature.


METHOD
A search was carried out for jurisprudential cases in which doctors were removed from the professional register during the period January 2006-December 2011, using the following sources: the websites of the disciplinary tribunals, the Dutch Government Gazette (Staatscourant) and two journals concerned with healthcare law. The verdicts were analysed, general statistical records were kept and categories for the consideration were set up on the basis of short, characteristic quotations from the verdicts. These verdicts were subsequently re-examined and divided into these categories.


RESULTS
A total of 34 verdicts concerning 13 different physicians were found in the study period. There were 17 verdicts from the RTGs and 16 verdicts from the CTG. One verdict was pronounced by the Medical Supervisory Board (CMT). In 12 cases the final verdict was permanent removal from the professional register. In one case the CTG imposed a lower sanction than that earlier imposed by the RTG. The most common considerations taken into account by removal from the professional register were the combination of medical-technical errors, incomplete and/or inaccurate maintenance of patient records and the doctor's attitude towards his or her own actions.


CONCLUSION
Removal from the professional register is rarely imposed. In most cases, an accumulation of obvious errors is involved. Improper sexual behaviour is also punished severely. Acting in accordance with professional medical standards, adequate medical record-keeping and self-reflection are important factors in the prevention of this sanction.