Healthy Skepticism Library item: 19354

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Publication type: news

Beckford M
Quarter of doctors failed to report incompetent colleague
The Telegraph 2011 Mar 7
http://www.telegraph.co.uk/health/healthnews/8366746/Quarter-of-doctors-failed-to-report-incompetent-colleague.html

Full text:

The investigation into professional values also found that almost one in five GPs and surgeons did not believe they had to put patients’ welfare above their own financial interests, a figure described as “surprising” by researchers.
In addition, nearly one in 10 respondents said they did not believe affairs with patients should always be off-limits.
The majority of doctors questioned admitted they had received free gifts and samples from drug companies, but almost half believed they should not have to tell patients about such relationships.
Niall Dickson, the Chief Executive of the General Medical Council, said in response: “As the study finds, there is strong support among UK doctors for the values set out in our guidance. There are some worrying findings however; including that one in four doctors did not raise concerns about another incompetent or poorly performing doctor, although it is clear that some of the doctors believed the concerns were being dealt with by others.
“Doctors have a clear duty to put patients’ interests first and act to protect them; this includes raising concerns about colleagues when necessary.”
The study, published online on Tuesday in the journal BMJ Quality and Safety, recorded the results of surveys completed by 1,891 doctors from the US and 1,078 from England and Scotland on “professional values and reported behaviours”.
Two-thirds of those who responded were male full-time family doctors, most of whom had been in practice for more than 20 years.
In general, only 59 per cent of the British doctors thought they should “report all instances of significantly impaired or incompetent colleagues to relevant authorities”, compared with 63 per cent of the American ones.
Almost one in five (18.7 per cent) British doctors said they had had “direct personal knowledge” of an incompetent colleague in recent years, but only 73 per cent said they had reported them to disciplinary bodies such as the General Medical Council.
Of those who had failed to inform the authorities, 34 per cent claimed it was because they feared “retribution” while smaller numbers said it was because they assumed others were taking care of the problem, or because they thought no action would be taken.
The authors wrote: “34 per cent of UK doctors did not report their colleague because they were afraid of retribution, possibly reflecting unsympathetic treatment of ‘whistleblowers’ which has been widely reported in the British medical press.”
Only 82 per cent of British respondents agreed with the statement that “doctors should put patients’ welfare above the doctor’s own financial interests”, and just 59 per cent thought they should “disclose their financial relationships with drug/medical advice companies to their patients”.
While 85 per cent said doctors should never lie to their patients, far fewer thought they were obliged to tell them about “significant medical errors” (70 per cent) or tell them about risks of proposed treatments (74 per cent).
“US doctors were more than twice as likely as their UK counterparts not to have disclosed an error because they were afraid of being sued, possibly reflecting the different malpractice environment in which US patients are much more likely to sue their doctors.”
Among British doctors, 91.7 per cent said it was “never appropriate” to have a sexual relationship with a patient, compared with 92.1 per cent of their American colleagues.
Just 7 per cent thought it was always wrong to accept “modest gifts” from patients or their families.
In a another blow to the GMC’s long-delayed plan to introduce five-yearly “revalidation” assessments to the profession, only 23 per cent of British doctors thought they should undergo such exams during their careers.