The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 52 RESEARCH ARTICLE ABSTRACTS South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 © 2016 The Author(s) RESEARCH South African Family Practice 2016; 58(3):108–113 http://dx.doi.org/10.1080/20786190.2016.1186366 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 Patterns of unprofessional conduct by medical practitioners in South Africa (2007–2013) Willem A Hoffmanna,i and Nico Nortjéb*,i  aDepartment of Biomedical Sciences, Tshwane University of Technology, Pretoria, South Africa b Department of Psychology, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: nortjenico@gmail.com A role of ethics in the medical context is to protect the interests, freedoms and well-being of patients. A critical analysis of unprofessional conduct by medical practitioners registered with the Health Professions Council of South Africa (HPCSA) requires a better understanding of the specific ethics misconduct trends. To investigate the objectives the case content and sanctions of all guilty decisions related to unprofessional conduct against HPCSA-registered medical practitioners in the period 2007 to 2013 were analysed. A mixed methods approach was followed. The quantitative component focused on annual frequency data regarding the number of decisions taken against practitioners, number of practitioners, number of specific sanctions and categories. Relatively few medical practitioners (between 0.11% and 0.24%) are annually found guilty of unprofessional conduct. The annual average number of guilty decisions per guilty medical practitioner ranged between 1.29 and 2.58. The three most frequent sanctions imposed were fines between ZAR10  000 and ZAR15  000 (28.29%), fines between ZAR1  000 and ZAR8  000 (23.47%) and suspended suspensions between 1  month and 1 year (17.37%). The majority of the unprofessional conduct involved fraudulent behaviour (48.4%), followed by negligence or incompetence in evaluating, treating or caring for patients (29%). Unethical behaviour by medical practitioners in South Africa occurs relatively infrequently. Keywords: ethical transgressions, fraud, HPCSA, Incompetence, negligence Introduction Ethics is a discipline of thought and study regarding the moral principles of human behaviour. In the medical context it focuses on the protection of the interests, freedoms and well-being of patients.1,2 Codes of Ethics are profession-specific guidelines for members of that profession to make responsible ethical choices and to encourage self-regulation and high levels of professional integrity.3 These codes should not merely be viewed as a set of legal rules, regulations and/or guidelines, but also as educational and informative instruments that can influence the ethical behaviour of practitioners and assist them in the actual decision- making process.3 However, the codes in themselves do not prevent unethical behaviour. Personal and professional integrity motivates health practitioners to maintain and develop high levels of ethical professional conduct as well as to stay abreast of the latest clinical skills and advances through continuous professional development activities.4 There is an increasing demand by the public to hold health-care providers liable for unprofessional conduct and as such they may lodge a complaint with the Health Professions Council of South Africa (HPCSA). In South Africa, the HPCSA is a statutory body that was established in terms of the Health Professions Act (No. 56 of 1974) to regulate the behaviour of health professionals, and which is committed to serving and protecting the public and offering guidance to registered health-care professionals.4 The HPCSA provides a process through which the public can lodge complaints of an ethical nature against health-care professionals whom they deem to have acted in an unethical way.8 Within seven days after receiving a complaint, the Registrar of the HPCSA needs to forward the complaint to the health-care professional concerned and request a written explanation from him/her. Upon receipt of the health-care professional’s explanation it is then referred to the Professional Board with whom the health-care professional is registered. However, note that health-care professionals may refuse to submit an explanation. A Professional Conduct Committee will hold a professional conduct enquiry in those cases where the Board decides that there are grounds for the complaint. If the professional conduct enquiry finds the health-care professional guilty of misconduct penalties may be instituted. The committee’s decision is final, unless either party lodges an appeal.8 Ethical conduct by health-care practitioners registered with the HPCSA is of critical importance to ensure the highest possible level and quality of health-care services to the public of South Africa. However, some practitioners on occasion fail to uphold these high values and practices, which then result in various forms of harm to patients, medical aid funds and/or the health-care system. As such, a better understanding of recent unprofessional and unethical conduct by medical practitioners can better inform the public, fellow medical practitioners and health-care system officials of problematic conduct areas and/or gaps in current ethics education programmes. In addition, the nature of specific sanctions and/or corrective actions imposed by the HPCSA can raise public trust in the formal mandate of the HPCSA in the Health Professions Act (Act 56 of 1974) to ‘serve and protect the public in matters involving the rendering of health services by persons practising a health profession’ (Paragraph 3(j)). Ultimately, it is intended to maintain and advance optimal health-care practices that recognise and respect patients’ human rights. The objectives of this study were the following: • to analyse the case content of all guilty decisions related to un- professional conduct of HPCSA-registered medical practition- S Afr Fam Pract 2015; DOI:10.1080/20786190.2016.1186366Abstract (Full text available online at www.tandfonline.com/ojfp) South African Family Practice is co-published by Medpharm Publications, NISC (Pty) Ltd and Cogent, Taylor & Francis Group S Afr Fam Pract ISSN 2078-6190 EISSN 2078-6204 © 2016 The Author(s) RESEARCH South African Family Practice 2016; 58(3):114–118 http://dx.doi.org/10.1080/20786190.2016.1182801 Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0 The needs and preferences of general practitioners regarding their CPD learning: a Free State perspective J Botesa*  , J Bezuidenhoutb, W J Steinberga  and G Joubertc  a Department of Family Medicine, University of the Free State, Bloemfontein, South Africa b Division of Health Sciences Education, University of the Free State, Bloemfontein, South Africa c Department of Biostatistics, University of the Free State, Bloemfontein, South Africa *Corresponding author, email: BotesJ@ufs.ac.za Background: The Health Professions Council of South Africa (HPCSA) requires all registered Health Practitioners in South Africa to complete accredited learning opportunities, and provide proof thereof. CPD is the chosen model, which focuses on holistic development of the professional. The UFS Department of Family Medicine presents refresher courses for general practitioners, covering all relevant fields of interest. Aim: The aim of this study was to find reasons and possible solutions for the perceived lack of interest in refresher courses by determining general practitioners’ needs and preferences for CPD training. Methodology: A cross-sectional study design was chosen, whereby a systematic sample of 300 general practitioners registered with the HPCSA as doctors in the Free State were asked to complete a questionnaire. Needs and preferences regarding learning opportunities and factors influencing usage of these learning opportunities were assessed. Results: The responses from 60 participants revealed that general practitioners still prefer the lecture form of presentations in large or small groups. Topics that ranked highly were Infective Diseases, Cardiology and Respiratory Diseases. Respondents indicated that general practitioners prefer not to leave their practices unattended for an extended period of time. Conclusion: Free State general practitioners still prefer the traditional lecture-room style of learning. Their declared learning needs are in line with the regular ailments they encounter within their practices. Strategies to accommodate those who find it difficult to attend, due to time and distance concerns, should be considered. Keywords: CPD, Free State, general practitioners, learning opportunities, refresher courses Introduction One of the medical professions that finds it the most difficult for staying in touch with current knowledge is the general practitioner. General practitioners are considered to be ‘on the edge’.1 They are required to have some knowledge of various related medical fields and are constantly under pressure to adapt the way they approach patients and their treatment. They need to have a holistic view of the patient’s health, family matters and any other factors that may influence the patient’s welfare. Furthermore, for general practitioners, the preventive plays as important a role as the curative. The main purpose of continuing medical education (CME) is to improve and maintain clinical knowledge and skills.2 The traditional manner in CME for clinical-related knowledge transfer was a lecture given by a specialist, pharmaceutical representative or another expert on clinically related topics. Adjustments needed to be made to adapt to a changing world and greater demands.3 In South Africa, the Health Professions Act of 19744 supported the development of continuing professional development (CPD) and tasked the Health Professions Council of South Africa with managing the process. Gibbs explains that CPD has become a holistic mode of training, which considers doctors to be much more than just clinicians.3 As of January 1, 2007, all registered health professionals in South Africa are required to attend and complete accredited learning opportunities with the purpose of updating and acquiring new skills and knowledge. The conversion to the CPD system was to develop the health practitioner as a complete professional, allowing for training in the medical field, ethics, personal health, practice management and medical law.5 Constant reflection and critical self-evaluation moves the onus from the manager to the individual for personal development in all aspects of his/her life.6 In South Africa, health practitioners are required to collect 30 Continuing Education Units (CEU) per year, which include five compulsory ethical discussion points. Training options include refresher courses, ward rounds, journal discussions, reviewing of journal articles, presentations, update meetings, conferences, research, media and Internet activities.5 The Department of Family Medicine at the University of the Free State has been presenting refresher courses for general practitioners since 1979. Through tri-annual courses, all the relevant topics are presented through triennial rotation. Courses are presented in cooperation with the topic-related specialist departments. The programme often also includes external guest speakers. Lectures are given in lecture format, with time given for group discussion. These courses are attended by doctors from across the country. Attendance at these refresher courses has dropped since the CPD requirements. The high attendance rate of the final course of the year may indicate that physicians realise their time for CEU accumulation is coming to an end and they need to accumulate points. S Afr Fam Pract 2015; DOI:10.1080/20786190.2016.1182801Abstract (Full text available online at www.tandfonline.com/ojfp)