Promoting good practice and managing poor performance in anaesthesia and pain medicine

The purpose of these guidelines is to provide advice to managers, leaders, mentors and colleagues on promoting an environment that supports excellent professional standards and to assist in identifying and managing practitioners performing below acceptable professional standard. 

There are many different practice settings in anaesthesia and pain medicine in Australia and New Zealand. These guidelines aims to cover both public and private practice. The managerial roles are more clearly defined in public practice. In both settings, but more often in private practice, it may be a colleague that finds themselves in the role of manager, adviser or mentor. 

Whilst experienced clinical directors will already understand and practice the principles contained in this guide, it is written primarily to support practitioners who may find themselves in a position to improve local support mechanisms or have been asked to assist a colleague where there are concerns about professional or technical performance. 

There are many factors that may impact on professionalism and skills over time. Supportive environments can minimise negative influences such as isolated practice or lack of learning opportunities. Feedback on performance can assist practitioners to make sensible choices about further study, skill development, coaching or retirement.

It is also well recognised that cognitive skills decline with age and that engagement in continuing professional development (CPD) is essential. 

The investigation and management of concerns about poor performance is a sensitive issue and there is considerable scope for the problem to be mishandled. Whilst this guide provides many opportunities to support clinicians by acknowledging the principles of natural justice and through the provision of remediation, patient safety is an absolute priority.


This guide consists of four sections and a page of references:

Content development group

This guide has been developed by: Dr Rowan Thomas, Dr Elizabeth Feeney, Dr Marion Andrew, Dr Gary Hopgood and Dr Jordan Wood.

Published February, 2017


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