BMJ  2004;329 (21 August), doi:10.1136/bmj.329.7463.0-g

Editor's choice

Demonstrating accountability, fostering trust

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

"Plants don't flourish when we pull them up too often to check how their roots are growing." Tom Treasure approvingly quotes this statement from Onora O'Neill's 2002 Reith lectures on trust and accountability (p 424). O'Neill's point is that "the culture of accountability that we are relentlessly building for ourselves [may actually damage] trust rather than supporting it."

Treasure is commenting on a study of the learning curve of newly independent surgeons doing coronary artery surgery (p 421). This study shows that mortality in patients operated on by surgeons in the first four years of independent practice is similar to that in patients operated on by more experienced surgeons but that mortality did decrease from 2.2% in the first year of independent practice to 1.2% in the fourth. Treasure's point is that coronary artery surgery is done in high volumes and outcomes are "extraordinarily good." He . . . [Full text of this article]

Jane Smith, deputy editor

(jsmith@bmj.com)


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