Position Statement – Medical Director

THE MEDICAL DIRECTOR OF AN ACCREDITED RESPIRATORY FUNCTION LABORATORY

A position statement of the Thoracic Society of Australia and New Zealand

Definition 

The Medical Director is a specialist Respiratory Physician who is appointed as a manager of a TSANZ accredited laboratory which undertakes respiratory physiological studies. In particular, the Medical Director must ensure the appropriate application of physiological testing to clinical need and the adequate provision for quality control and patient safety in conjunction with the Scientific Director/Senior Scientist of the laboratory. The Medical Director is responsible for the prompt and accurate interpretation and reporting of test results and their communication to the referring practitioner. 

Who Does This Apply To? 

All Medical Directors who were in a post as a Medical Director as at 1st June 2019 are deemed to have met the training requirements detailed in this document and have been automatically ‘grandfathered’ with respect to meeting the requirements for training. 

All Medical Directors, regardless of the date of appointment, are required to demonstrate they have achieved the Continuing Medical Education requirements detailed below by 31st Dec 2022. 

Qualifications 

1. Training 

1. Registered specialist medical practitioner in Respiratory Medicine (FRACP or equivalent) in Australia or New Zealand. 
2. Five years’ clinical practice experience post FRACP qualification, including respiratory function laboratory testing and reporting in a TSANZ accredited service. 
3. At least one year of clinical practice experience post FRACP qualification must be in a TSANZ accredited respiratory function laboratory offering a range of complex lung function testing, including inhaled bronchial challenges and cardio-pulmonary exercise testing. 
4. Attendance at a minimum of 3 post-graduate courses (run by relevant national or international societies) in respiratory or exercise physiology, clinical respiratory function testing or clinical exercise testing (see glossary for a description of acceptable courses). 
5. Attendance at the TSANZ Laboratory Assessor Development Program. 

2. Continuing Medical Education

1. Attendance at the TSANZ Annual Scientific Meeting at least once every three years. 
2. Attendance at a minimum of one post-graduate course in respiratory or exercise physiology, clinical respiratory function testing or clinical exercise testing every four years (see glossary for a description of acceptable courses).. 
3. Participation as a TSANZ Laboratory Assessor at least once every four years. 

Competency 

The Medical Director must be familiar with all the respiratory function testing equipment and be knowledgeable about normal and abnormal cardiorespiratory physiology. This must be combined with clinical experience in order to evaluate the significance of laboratory findings in relation to patient care. A working knowledge of medical instrumentation, computer utilisation and statistics is essential. 

Responsibilities 

1. The Medical Director, when employed by a hospital, is accountable to the hospital administration and professional staff. When working in the private non-hospital setting, accountability will depend on the particular circumstances of the work. It is the Director’s responsibility to ensure the laboratory reaches an overall standard that qualifies for accreditation by the Thoracic Society of Australia and New Zealand. 
2. The Medical Director will share in conjunction with the Scientific Director/Senior Scientist the overall responsibility for the appointment, supervision, training and evaluation of staff who are assigned to work in the respiratory function laboratory. 
3. The Medical Director will share the overall responsibility, with the Scientific Director/Senior Scientist, for the development of a manual detailing the work of the laboratory in accordance with the professional and hospital standards required for accreditation by the Thoracic Society of Australia and New Zealand. Additional accreditation may be required from other authorities regarding pathology tests such as blood gas measurements. The Medical Director in conjunction with the Scientific Director/Senior Scientist must ensure that quality control and infection control systems exist, and that appropriate records are maintained. 
4. The Medical Director must keep under constant review the appropriateness of the patient referrals for respiratory function studies. Where there is a significant risk to the patient, the study must be carried out under the supervision of the Medical Director or a medically qualified designee. It is the responsibility of the Medical Director to ensure that potentially clinically hazardous procedures are appropriately recognised and that corrective measures are properly planned and taken when necessary. Protocols must be established to delineate responsibilities in such cases. 
5. The Medical Director will have overall responsibility for the accurate interpretation of the results of all respiratory function studies which must be promptly communicated to the referring practitioner. It is the responsibility of the Director to ensure that practitioners reporting studies from his/her laboratory are competent to do so. 
6. The Medical Director in conjunction with the Scientific Director/Senior Scientist will have responsibility for the workload and budget for the respiratory function laboratory 
7. The Medical Director must maintain a continuing interest in developments in the field of respiratory function testing, however, the Scientific Director/Senior Scientist will be responsible for researching and introducing new equipment and devices. It is the responsibility of the Medical Director, in consultation with the Scientific Director/Senior Scientist, to ensure that the respiratory function laboratory techniques and equipment are upgraded when necessary to maintain standards of accuracy and cost effectiveness, and to introduce useful innovations. 
8. The Medical Director must maintain affiliation with professional organisations and attend appropriate meetings to ensure continuing education in respiratory function, respiratory medicine and physiology. It is the responsibility of the Medical Director to serve as a continuing education resource to professional staff and to those employed within the department. Liaison with other directors and relevant experts outside the field, such as biomedical engineers and statisticians, is important to help ensure the high quality of performance of the laboratory. 
9. The Medical Director should participate in public and patient education and should serve as a resource to the community for improving public knowledge in respiratory physiology and respiratory medicine. 

Glossary 

1. TSANZ Assessor Development Program: The annual training course for Laboratory Accreditation Assessors and Laboratory Staff run in conjunction with the TSANZ Annual Scientific Meeting. 
2. Post-graduate courses: Half or full day courses or symposia which covers respiratory or exercise physiology, clinical respiratory function testing or clinical exercise testing, or any other topic relevant to a Respiratory Function Laboratory. Suitable national or international societies include but are not limited to TSANZ, ANZSRS, ATS, ERS and APSR. 
3. TSANZ Laboratory Assessor: A member of a TSANZ laboratory accreditation panel who participates in the accreditation of a respiratory function service. 

Authors 

Prof John Wheatley 
Prof Bruce Thompson 
Prof Iven Young 

V2 June 2017 
V3 February 2019 

Click here to download a PDF of the position statement of the Medical Director of an Accredited Respiratory Function Laboratory.