Doctors

Doctors on Brandywine can practise in different ways. Some may work within organised offices and others may choose to practise independently or travel.

All of those approaches are valid.

The purpose of this handbook is to establish the boundaries between those different styles of med RP so that structured medical offices can have meaningful RP without travelling/independent doctors being forced underneath them.

The basic principles are:

• A medical licence is separate from membership of any Doctors Office or association.
• Doctors Offices can manage their own members and decide on internal structure.
• Travelling doctors remain legitimate independent doctors, but independence doesn't allow them to ignore or undermine existing medical RP.
• Law enforces criminal law. The Medical Licensing Board deals with whether somebody remains fit to be a doctor.

Medical Licences

All recognised doctors must hold a valid medical licence. 

A medical licence confirms that somebody is permitted to practise medicine. It can be shown to patients, other doctors or law.

Leaving or being removed from an office doesn't automatically mean a medical license is lost.

Serious criminal conduct, serious professional misconduct, continued inactivity or repeated failure to properly participate in the Doctor role may result in a licence review.

Medical Licensing Board

The Medical Licensing Board exists separately from any other Doctor organisation.

Its purpose is limited to matters relating to professional licensing and suitability to practise medicine.

This may include:

• Issuing and maintaining medical licences.
• Serious professional complaints.
• Serious or repeated misconduct.
• Complaints involving office leadership.
• Inactivity or failure to meaningfully perform the Doctor role.
• Evidence submitted by Law relating to a doctor's professional suitability.

The Licensing Board is not responsible for minor, in office disputes.

Who Can Contact the Licensing Board

The Medical Licensing Board may only be contacted directly by:

• Doctors
• Law

Members of the public should raise concerns with an appropriate doctor, office leadership or Law depending on the situation.

Communication with the Board will take place through telegrams.

Submitting a matter to the Board doesn't guarantee that action will be taken. Evidence, context and the seriousness of the issue will be considered before any decision is made.

Licence Reviews, Suspensions & Revocations

A doctor shouldn't lose their medical licence simply because they have committed an unrelated offence.

Law cannot independently revoke somebody's licence.

Where serious conduct may affect somebody's suitability to continue practising medicine, evidence should be submitted to the Medical Licensing Board for review.

Law & Medical Licensing

Law enforce the law, they don't run the medical profession or licensing board.

Law may investigate doctors, arrest doctors and charge doctors where criminal conduct is involved.

If Law believes that conduct is also serious enough to affect somebody's ability to remain a doctor, the relevant evidence should be submitted to the Medical Licensing Board.

Doctors Offices

Doctors Offices may operate as independently managed medical organisations with the freedom to develop its own leadership and internal structure.

This may include:

• Lead Doctors.
• Internal ranks.
• Training / Procedures.
• Supplier relationships.

An office has authority over its own members, organisation and resources.

It does not automatically have authority over every doctor working within the wider jurisdiction where the office is based.

Office Leadership & Internal Structure

Lead Doctors are free to develop the structure that works for their office.

This may include appointing responsibilities, training doctors, creating internal expectations and deciding how the office operates.

Doctors who choose to work within that office are expected to engage with that structure through RP.

Normal internal disputes should also be dealt with through RP wherever possible.

As the office system develops, certain amenities may become managed by the individual office rather than free/full access as they are now.

Medical Associations & Societies

Doctors are free to create associations, societies and other organisations through RP.

Multiple offices may choose to:

• Share responsibilities.
• Establish an overall Head Doctor.
• Develop shared procedures.
• Form a wider medical society.

None of this requires staff to appoint somebody as the leader of all doctors.

If five offices wish to join an association and one office doesn't, the remaining office is free to remain independent.

An association represents the doctors and offices that choose to participate in it. It doesn't automatically gain legal authority over non members.

Player Created Medical Structures

Doctors are encouraged to create meaningful organisations through RP if that's what they want to do.

However, if players choose to create leadership structures, associations or hierarchies themselves, the consequences of those decisions must also be roleplayed.

Staff should not be expected to step in and resolve every internal political disagreement simply because an organisation later develops problems.

If a group elects somebody as its leader and later becomes unhappy with that leadership, that is generally something to resolve through RP.

Staff involvement may still occur where server rules are actually being broken, but staff are not there to undo the normal consequences of player-created organisational RP.

What Is a Travelling Doctor?

Travelling doctors are licensed doctors who practise independently rather than permanently working under one Doctors Office. 

Travelling doctors remain a fully supported form of medical RP.

They may move between towns, respond to emergencies across the state and practise without being part of an office hierarchy.

New Travelling Doctors & Onboarding

New doctors who ultimately wish to practise independently will first be expected to spend time working with an established Doctors Office.

This is intended to provide:

• Proper onboarding.
• Experience with medical systems.
• Exposure to medical RP.
• Mentoring from established doctors.
• A baseline understanding of the responsibilities that come with being a doctor.

Once that onboarding period is complete and the doctor has demonstrated that they are ready to practise independently, they may choose to remain with an office and rise through the ranks or become a travelling doctor.

Travelling Doctor should be a style of medical practice, not a way to bypass training or accountability.

Working Within Established Towns

Travelling doctors may respond to emergencies anywhere in the state.

They do not require permission from a local office simply to help an injured person.

They may also practise medicine in towns where established Doctors Offices exist.

However, a travelling doctor should not use their independent status as a way to permanently operate inside one town while avoiding all relationships with the medical structure already established there.

When a Travelling Doctor Stops Being "Travelling"

Travelling doctors are expected to actually travel.

If somebody repeatedly:

• Practises primarily from the same town.
• Regularly responds to that town's medical calls.
• Treats that location as their normal base of operations.
• Effectively operates as a resident doctor.

Then they may no longer reasonably be considered a travelling doctor.

Where a clear pattern develops, the Medical Licensing Board may review how that doctor is practising.

This will not be based on arbitrary rules such as "X number of calls means you now live there".

The overall pattern and context will matter.

Independent Doctors & Existing Medical RP

Being independent means that a doctor is not subordinate to another office's internal hierarchy.

It does not mean that other medical RP can simply be ignored.

Independent doctors:

• Do not have to join an office.
• Do not have to join a medical association.
• Do not have to agree with office leadership.
• Do not have to like the way another office operates.

However, they must still acknowledge and reasonably engage with the medical RP taking place around them.

An independent doctor cannot simply pretend that:

• Doctors Offices do not exist.
• Medical associations do not exist.
• Contracts and agreements between other doctors do not exist.
• Patient records do not exist.
• Ongoing treatment does not exist.
• Established medical organisations have no place in the world.

Choosing not to join something does not make that RP invalid.

Deliberately ignoring, avoiding or discrediting established medical RP simply because you chose not to participate in the organisation behind it is not acceptable.

At the same time, organised doctors cannot use their structure to force independent doctors to obey internal rules that do not apply to them.

Professional Cooperation

Doctors do not need to like one another.

They do not need to agree on how medicine should be organised.

They may have rivalries, disagreements and conflicting approaches through RP.

They are still expected to reasonably cooperate where patient care requires it.

This may include:

• Patient handovers.
• Relevant medical records.
• Ongoing treatment.
• Serious medical incidents.
• Sharing appropriate information.
• Avoiding deliberate interference with another doctor's ongoing treatment.

Complaints About Doctors

Doctors remain professionally accountable regardless of whether they are part of an office or practise independently.

Complaints Within an Office

Complaints involving a doctor who belongs to a Doctors Office should generally be raised with that office's leadership first.

Normal internal conduct issues should be given an opportunity to be handled through office RP.

Complaints About Office Leadership

Where a complaint involves:

• A Lead Doctor OR Senior office leadership.
• Serious misconduct.
• Whether somebody should remain licensed due to criminal conduct.

The complaint may be escalated to the Medical Licensing Board.

Complaints About Travelling Doctors

Travelling doctors do not have office leadership responsible for their conduct.

Serious complaints involving travelling or independent doctors may therefore be raised directly with the Medical Licensing Board.

Law Investigations

Law may investigate any doctor where criminal conduct is suspected.

The fact that somebody is a doctor does not shield them from arrest or prosecution. However, an arrest alone does not automatically remove somebody's medical licence.

Where Law believes the conduct also raises concerns about somebody continuing to practise medicine, the evidence should be referred to the Licensing Board.

Professional Misconduct

Professional misconduct may include serious behaviour that calls into question whether somebody should continue practising medicine.

Not every disagreement, mistake or IC dispute should become a Licensing Board case.

The Board should be reserved for issues serious enough to potentially affect somebody's medical licence and the evidence submitted should be compelling.

Activity Requirements

Doctor is an active whitelisted role.

Holding a medical licence requires meaningful participation in medical RP.

Doctors who repeatedly remain clocked in for substantial periods while doing little or no actual medical work may be subject to review.

Examples may include repeatedly:

• Ignoring medical calls.
• Treating no patients.
• Writing no treatment reports.
• Responding to no medical incidents.
• Producing little or no meaningful medical activity.

Doctors who become inactive for extended periods may have their licence reviewed.

Clocked In Without Medical Activity

Clocking in is not meaningful Doctor activity.

Server audit systems will be used to identify doctors who spend substantial time clocked in while producing little evidence of actually performing the role.

Legal Crops & Dried Materials

Growing any crop is legal.

Possession of crops in their base or dried form is also legal.

Individual Doctors or Offices cannot create their own criminal laws around crops.

Illegal Bundled Drugs

Bundled drugs are considered goods prepared for trafficking and are illegal.

Processed & Prohibited Drugs

Processed prohibited substances are:

• Cannabis Cigarettes
• Coca Chew
• Prepared Opium
• Pressed Hashish
• Moonshine

Possession of these is illegal, even for doctors. Possession of them does not mean your medical license will be immediately revoked.

Doctors do not receive blanket immunity from drug laws simply because they practise medicine, however law should still use reasonable IC judgement based on:

• Quantity.
• Circumstances.
• Medical context.
• Evidence of trafficking or dealing.

A doctor carrying a small quantity of illegal drugs in a believable medical context is very different from a doctor being caught dealing or transporting hundreds of illegal items.

Office Approved Suppliers

A Doctors Office may decide that it only wishes to purchase from particular approved suppliers.

Using a supplier who is not approved by that office does not make the supplier a criminal or the act illegal, it's just a matter of internal policy and Doctors Office preference. Going against these arrangements can be handled as per that Offices guidelines.

Law Enforcement & Medical Context

Law should enforce the actual law rather than dealing with internal medical policies or issues.

Office agreements, supplier lists or association rules do not automatically become criminal law.

Where doctors or offices believe professional misconduct has occurred, that should be dealt with through the appropriate office leadership or the Licensing Board, law only need to be involved if criminal conduct has occurred.