Bmj Usa: Letter


BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E44

This article originally appeared in BMJ USA

A letter from Stanley Shere, published in the April 21 issue of the “BMJ,” argued that it is dangerous when physicians dictate letters but then fail to read or sign them. As of May 19, 30 rapid responses had been posted on in response to Shere's letter. Below we reproduce Shere's letter and a sampling of the rapid responses.—Editor

Not reading and signing letters you have dictated is dangerous

  1. Stanley Shere, consultant psychiatrist
  1. Woodley House, Nackington Road, Canterbury, Kent CT4 7AX, UK
  2. Cleveland, Queensland, Australia
  3. Whiston Hospital, Prescot, Merseyside L35 5DR, UK
  4. Ysbyty Gwynedd, Bangor, UK
  5. Exeter, UK
  6. International Atomic Energy Agency, Vienna, Austria
  7. Rotherham District General Hospital, UK
  8. Helsingborg, Rehabklinik, Sweden
  9. Peterborough District Hospital PE3 6DA, UK
  10. Ealing Hospital, Southall, Middlesex UB1 3HW, UK

    This article originally appeared in BMJ USA

    Editor—For some time I have been unhappy at the number of letters that I receive unsigned, usually from fellow consultants but more recently also from general practitioners. After the warm best wishes at the end of the letter they usually state “Dictated but sent unsigned to avoid delay”; as we both know, this is almost always totally untrue.

    I know many consultants who virtually never sign their letters and, worryingly, never read them after dictating them. To add insult to injury, I recently saw a copy of a letter from a consultant to a general practitioner, unsigned and from the mistakes obviously unread, in which he had the cheek to encourage the general practitioner to send patients for assessment at the private hospital where he worked.

    Last year I returned from having spent one month in the United States; there was an enormous amount of post awaiting my attention, much of it medical. The final trigger to my writing this letter was that of this large number of letters (mostly from fellow consultants but also from general practitioners), over half were unsigned and had that dishonest explanation in lieu of a signature. Several years ago I recall reading a letter in a newspaper from a medical colleague expressing concern about this matter, and he neatly and precisely gave his view—which I share—that the practice is both …

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