Will the lead clinician please stand up?

doi:10.1136/bmj.330.7493.737

BMJ 2005;330:737 (26 March), doi:10.1136/bmj.330.7493.737

reviews

PERSONAL VIEW

Will the lead clinician please stand up?

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

Medicine is not a pure science, and doctors are human. Althoughindividual mistakes are inevitable and can even be enlightening,complacency remains unacceptable. Healthcare systems must minimiseerrors and should require an approach that is as evidence basedas our approach to prescribing (and with an impact that is atleast equivalent). In the case I describe here the "uncontroversial"progress in multidisciplinary working by the cancer team undermined,paradoxically, the traditional role of the lead clinician, allowingavoidable harm to the patient to occur without evoking concern.

A fully independent elderly woman presented with lithium toxicityearly last year. Depression was her only recent illness. Shewas discharged after her lithium dosage was reduced, withoutspecific assessment or follow-up for mild renal impairment (hercreatinine concentration was 180 µmol/l).

She presented again two months later with a 5 cm lump in herbreast. An outpatient review followed within . . . [Full text of this article]

Craig Gannon, consultant in palliative medicine

Esher, Surrey craiggannon@pah.org.uk

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Good general practitioners will continue to be essential: Mayur Lakhani and Maureen Baker
BMJ 2006 332: 41-43. [Full Text] [PDF]

Will the lead clinician please stand up?: That'll be the general practitioner: Maurice Conlon
BMJ 2005 330: 966. [Extract] [Full Text]

Will the lead clinician please stand up?: We should be promoting total quality care: Graham Neale and Sisse Olsen
BMJ 2005 330: 966. [Extract] [Full Text]

Heading where exactly?: Fiona Godlee
BMJ 2005 330: 0. [Extract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

That'll be me, then: Maurice Conlon
bmj.com, 26 Mar 2005 [Full text]
The lead clinician should have been a nephrologist: Hugh C Rayner
bmj.com, 26 Mar 2005 [Full text]
GP computer as safety net?: David J Young
bmj.com, 27 Mar 2005 [Full text]
It can only get worse: Bob Bury
bmj.com, 29 Mar 2005 [Full text]
The lead clinician is standing up, but is likely to fall over.: James N hardy
bmj.com, 1 Apr 2005 [Full text]