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Editor’s  Corner
A Call for Competence-Driven Healthcare Technology:
The Right to Repair and Clinical Engineering Competency

 The debate surrounding “Right-to-repair” has reached 
clinical engineering, sparking a crucial discussion about 
technical expertise and patient safety. On one hand, 
healthcare providers question why they cannot choose 
service providers for their medical equipment, obtain 
replacement parts, and manuals given their investment in 
acquiring and maintaining its performance. On the other 
hand, the industry raises concerns about the specialized 
training and qualifications necessary for safe and effective 
maintenance of sophisticated devices..

This debate hinges on the concept of competency: the 
ability to perform a task effectively. In healthcare, where 
lives hang in the balance, ensuring competency should be 
paramount. Unlike a simple household appliance, medical 
equipment demands intricate knowledge, experience, 
specialized tools, and a deep understanding of its intri-
cacies. Therefore, simply owning the device should not 
grant automatic repair rights. As you can see on the cover 
page of this issue, we encourage further understandings 
of professional stewardship characteristics especially as 
it refers here to engineering competency. The foundation 
of competency lies in education, discipline boundary, 
skills sustainability, and compliance with professional 
credentialing. From the wisdom of the book of Proverbs, 
the biblical anthology of saying and instructions, (“Dis-
cretion will watch over you, understanding will guard 
you...”) to the Latin root “competere”, which is a combi-
nation of “com” (“together” or “with”) and “petere” (“to 
seek” or “go towards”). Therefore, the literal meaning is 
seeking or suitable to go together, having competence. 
Over time, the term evolved generally to represent the 
ability, capacity, or fitness to perform tasks or function 
effectively. It is commonly used now to describe a set of 
skills, knowledge, and attributes that make an individual a 
capable and qualified practician in a particular field, role, 

or task. In healthcare, ensuring patient safety necessitates 
demonstrable competent stewardship, including from 
the professionals who ensure that patient care medical 
technology is safe and effective. 

As healthcare grows ever more technology-intensive 
and its reliance on that technology increases, the Clinical 
Engineering profession competency becomes ever so 
more vital. Patient who enters the healthcare system for 
the treatment of their disease or abnormal condition may  
be unable to understand and to make decisions about 
the technology that is about to be used during the treat-
ment or management of their condition. Further- more, 
patients may be unable to fend for him/herself due to 
receiving medications or anesthetic drugs that render 
them unconscious, unable to make decisions.

 In such situations patients are appropriately expect 
that members of the healthcare team will ensure that 
the technology used on them is safe and effective. The 
care team includes clinical engineering practitioners. 
While physicians are taking the historical Oath of Ethics 
known as “Hippocratic oath”, engineers are also bound 
by the “First do no harm” (in Latin Primum non nocere) 
and by the engineer’s creed contained in Professional 
Engineer ethical oath.1 

Assessing and maintaining competency requires a 
multi-pronged approach:

• Technical knowledge: Examining expertise in 
relevant systems, protocols, and troubleshooting.

• Risk management: Evaluating the ability to identify 
and mitigate potential risks associated with equip-
ment operations and maintenance.

• Problem-solving skills: Assessing the capacity to 
diagnose and resolve technical issues effectively.

• Communication skills: Ensuring clear and concise 
communication with stakeholders, including health-
care professionals and patients.

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3 J Global Clinical Engineering Vol.6 Issue 2, 2023

• Project management: Evaluating the ability to 
manage equipment maintenance projects efficiently 
and effectively.

• Ethics and professionalism: Assessing adherence 
to ethical principles and professional standards.

• Continuous learning: Evaluating commitment to 
ongoing learning and knowledge acquisition.

The methods for measuring competency range from 
performance assessments and technical examinations to 
peer reviews and self-assessments. Ideally, the approach 
should be tailored to the specific context and goals of the 
organization and the engineering discipline. However, a 
global baseline of competency is essential to ensure safe 
patient outcomes.

The debate around “Right-to-repair” ultimately boils 
down to who should determine competency: the industry 
or the healthcare provider? We, as clinical engineers, must 
advocate for competency-based access, demonstrating our 
value through education, professional credentialing, and 
ethical practice. This will pave the way for a future where 
clinical engineering is recognized as a “free” profession2,  
empowered to make decisions based on expertise and 
not external constraints.

Join the conversation! Share your thoughts on the 
“Right-to-repair” debate and how we can achieve com-
petency-driven healthcare technology management 
programs. If you’re not yet accredited, let us know how 
we can help you on your journey towards professional 
recognition. Global Clinical Engineering Alliance and the 
Global Clinical Engineering Journal will look forward to 
your response.

We can ensure that patient safety remains the corner-
stone of our discipline, and that means, that together we 
can make it better.

REFERENCES 

1. The Professional Clinical Engineer, Y. David, Journal 
of Clinical Engineering, Sept/Oct 1988.

2. Is Clinical Engineering an Occupation or Profession?, 
Y. David et al, Global Clinical Engineering Journal, Vol. 
4, Issue 2, 2021.  

Copyright © 2024. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY): Creative Commons - 
Attribution 4.0 International - CC BY 4.0. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright 
owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction 
is permitted which does not comply with these terms.

Have a wonderful and productive 2024!

Dr. Yadin David

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