Intended for healthcare professionals


Do you admit to working within the system?

BMJ 2000; 321 doi: (Published 23 September 2000) Cite this as: BMJ 2000;321:768

Culture of not telling tales has to end

  1. Patrick Bower, clinical governance lead (
  1. Balham, Tooting and Wandsworth Primary Care Group, London SW18 4EA
  2. University of London, St George's Hospital, London SW17 0QT

    EDITOR—Richard wonders if he should admit to being a doctor when the casualty officer misses his daughter's fracture and, even after seeing the x ray film, gets the diagnosis and treatment wrong.1 There is no dilemma. The casualty officer is a poorly performing doctor. He is not only lacking in knowledge but, seemingly, unaware of his own ignorance.

    Do his seniors know this? What help does he need to become a better doctor? Does the department provide proper training for its senior house officers? Do they have guidelines for use of radiography?

    If the NHS is ever to be a first class service we need to learn to use such incidents constructively. The accident …

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