Advice centre

Non-therapeutic circumcision of male children is carried out for religious or ritual reasons and is generally not available on the NHS.1 There is also a significant issue related to the appropriateness of the facilities in which the operation is carried out and a lack of formal training and certification in circumcision.

Removing patients from the practice list is an emotive issue and should only be used as a last resort. The reasons for removing a patient from the list can be varied, but it should not be in response to patients lodging a complaint or failing to comply with treatment.

Good medical records – whether electronic or handwritten – are essential for the continuity of care of your patients. Adequate medical records enable you or somebody else to reconstruct the essential parts of each patient contact without reference to memory. They should therefore be comprehensive enough to allow a colleague to carry on where you left off.

Patients who are kept informed about their condition and are involved in deciding on the appropriate treatment are more likely to comply with the treatment you suggest, and less likely to complain if things go wrong.

The medical consultation is a challenge to both doctor and patient, whether in the community or in hospital. The need for more detailed discussions with patients, along with their increasing autonomy and right to make choices in relation to their clinical care and treatment, has affected the traditional role of the doctor-patient relationship. This has made maintaining appropriate professional boundaries in the doctor-patient consultation more challenging, however, the guidance from national and regulatory bodies is clear that it is always the health professional's responsibility to do so.