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BMJ 2005;331:965-966 (22 October), doi:10.1136/bmj.331.7522.965-c
EDITORThe question whether chief executive officers (CEOs) in both the NHS and the private sector deserve their pay rises is not asked and does not generate articles describing detailed and arbitrary formulas and parameters for pay increases as it was for general practitioners.1 How many grossly inflated severance packages have we seen in recent years given to people, self important people, who have not infrequently received knighthoods for their financial prowess, but who have also presided, with their great acumen, over the failures of several important companies?
Yet general practitioners who see 40 plus patients a day and have to tease out the minor from the majorand heaven help them if something is overlooked, which with that volume is a nigh certainty at some pointare subject to this thicket of performance parameters.
Marx once said that he who controls the means of production controls the means of mental production in a societythat is, the ideology. One thing is clear: doctors are certainly not in control of the ideology related to their own profession. When a doctor fails he or she is subject to scrutiny and discipline and possibly worse. When a CEO fails, it is not failure, and even if it is, well there's always the next trust or company to administer... and maybe even ruin. But then there's that richly deserved severance package.
Richard Rosin, consultant psychiatrist
VA Medical Center Puget Sound, Seattle, WA 98108, USA richard.rosin{at}med.va.gov