Intended for healthcare professionals


All doctors are problem doctors

BMJ 1997; 314 doi: (Published 22 March 1997) Cite this as: BMJ 1997;314:841

Doctors worldwide must do better with managing problem colleagues

  1. Richard Smith, Editor BMJa
  1. a London WC1H 9JR

    Britain has in the past few weeks heard much about “problem doctors,”1 2 and a book has just been published on the subject.3 The public reaction to the cases reminds us that self regulation for doctors is not a right but a privilege that has to be deserved every day. And the book makes clear that doctors worldwide do badly with managing their problem colleagues. It also shows that in a sense all doctors are problem doctors. That is why we do so badly.

    A fatal accident inquiry in Scotland heard how surgeon Gerald Davies operated on patients when he had a blood alcohol concentration that was probably twice the legal limit for driving1; while Britain's General Medical Council struck off obstetrician and gynaecologist Patrick Ngosa for continuing to treat patients when he was infected with HIV.2 Both cases led to calls for compulsory testing of doctors for alcohol or HIV, and the sheriff hearing the Scottish case observed: “There appears to be a culture among members of the medical profession where it is regarded as inappropriate … to report on certain matters, including in particular a colleague's apparent excessive drinking.”1 Sun columnist Anne Robinson put it more starkly: “In truth there is not a single reason to suppose these days that doctors can be trusted any more than you can trust British Gas, double glazing salesmen, or the man in the pub.”

    We shouldn't be surprised by problem doctors. Why wouldn't they exist? Think how surprised we would be by a community of 130 000 people (the number of doctors in Britain) where nobody …

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