Letters

Not reading and signing letters you have dictated

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7310.448 (Published 25 August 2001) Cite this as: BMJ 2001;323:448

Not signing letters saves time

  1. Timothy Rimmer, consultant eye surgeon (timothy.rimmer@talk21.com)
  1. Peterborough District Hospital, Peterborough PE3 6DA
  2. Ysbyty Gwynedd Hospital, Bangor, Wales LL57 2PW
  3. Rotherham District General Hospital, Rotherham S60 2UD
  4. Northampton General Hospital, Northampton NN1 5BD
  5. Helsingborg Rehabklinik, Sweden
  6. Whiston Hospital, Prescot, Merseyside L35 5DR
  7. School of Law, University of Central England, Birmingham B42 2SU
  8. Homefield Surgery, Exeter EX1 2QS
  9. International Atomic Energy Agency, Vienna International Centre, Vienna 1400, Austria
  10. BMJ

    EDITOR—Shere writes that not reading and signing letters you have dictated may be dangerous, but I disagree with most of most of what he says.1 Perhaps some other doctors do not have as many letters to sign as I do: to scrutinise and sign every routine clinic letter would mean that I would no longer be able to keep my head above the paperwork. Dreary work is bearable if it is useful, but what is the return for checking routine letters for the odd spelling mistake? Shere mentions a mistyped drug dose error that could have been lethal. No doctor should base his or her drug doses solely on another doctor's letter, signed or not.

    A signed letter is certainly more courteous than an unsigned one, but I hope that general practitioners in my area realise that an unsigned letter was dictated with just as much courtesy, that my stress levels are kept in check by sending unsigned letters, and that unsigned letters will arrive more quickly. I would postulate that what general practitioners really do not like are long and unstructured letters in which it is difficult to pick out essential information such as diagnosis, treatment (lethal or otherwise), and when the next appointment is.

    I started adding “Please accept unsigned to avoid delay” to my letters five years ago. That was some economy of the truth, I admit. But “Please accept this unsigned to avoid delay and because the prospect of unnecessarily signing 2000 or 3000 letters a year fills me with nausea and will bring on my early departure from the NHS” would not have struck the right tone.

    References

    1. 1.

    Not signing letters means that they get sent out quickly

    1. Mel Jones, consultant orthopaedic and trauma surgeon (mel.jones@btinternet.com)
    1. Peterborough District Hospital, Peterborough PE3 6DA
    2. Ysbyty Gwynedd Hospital, Bangor, Wales LL57 2PW
    3. Rotherham District General Hospital, Rotherham S60 2UD
    4. Northampton General Hospital, Northampton NN1 5BD
    5. Helsingborg Rehabklinik, Sweden
    6. Whiston Hospital, Prescot, Merseyside L35 5DR
    7. School of Law, University of Central England, Birmingham B42 2SU
    8. Homefield Surgery, Exeter EX1 2QS
    9. International Atomic Energy Agency, Vienna International Centre, Vienna 1400, Austria
    10. BMJ

      EDITOR—I gave up signing my clinic letters seven years ago and end them with “dictated but not signed by…”1 The main reason I gave up signing …

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