Target centred medicine: ... and fail patients too

doi:10.1136/bmj.327.7416.680-a

BMJ 2003;327:680 (20 September), doi:10.1136/bmj.327.7416.680-a

Letter

Target centred medicine

... and fail patients too

The first 150 words of the full text of this article appear below.

EDITOR—According to MPs, NHS staff are cheating to hitgovernment targets.¹ Many readers will not be surprised to readof stories of wheels being removed to rename a trolley as abed, this problem has a more serious side. Through the use ofpunitive targets the government has tried to lead us from thegold standard of patient centred care to a new "target centred"brand of medicine.

The targets seem chosen for their ease of measurement ratherthan their clinical effectiveness. Where is the evidence basefor these targets? Why is the same target used for a minor grazeas for a polytrauma case? We have had numerous examples of patientsbeing admitted purely to avoid breaching the four hour accidentand emergency wait.

At best this has ended in an immediate discharge for an inappropriateadmission, with all the attendant increase in costs and decreasein . . . [Full text of this article]

Anthony A D'Sa, senior house officer orthopaedics

antdsa@hotmail.com

Sapna Agrawal, senior house officer accident and emergency, Alistair Tindall, orthopaedic specialist registrar, Alfred Franklin, orthopaedic consultant

Princess Royal University Hospital, Orpington, Kent BR6 8ND