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Press Press

Doctors under fire

BMJ 2002; 324 doi: (Published 05 January 2002) Cite this as: BMJ 2002;324:55
  1. Caroline White, freelance medical journalist

    How can they answer back?

    When a doctor is in the news, it is usually a story of alleged professional negligence or misconduct. All that human interest and drama, combined with the inevitable fall from grace, make for good copy.

    A crude trawl of press coverage in November last year revealed a different story of doctors reportedly bungling, blundering, or groping their way through headlines for almost every day of the month. The Medical Defence Union (MDU) now receives more than six inquiries a week to its media advisory unit, up from the same number a month in 1993.

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    (Credit: PA PHOTO)

    Press Complaints Commission chairman Lord Wakeham (left) and Society of Editors director Bob Satchwell display the code of conduct: should it be amended to protect doctors?

    While a recent BMJ study of three national newspapers found that the proportion of negative doctor stories had not changed in 20 years, it also found that coverage of health had more than tripled, producing an absolute increase in unfavourable column inches for doctors (

    As doctors submit to increasing scrutiny and the General Medical Council clears its backlog of complaints, there's likely to be a glut of source material. And there have been calls from some quarters for greater constraints on media reporting.

    The print media code of practice demands prompt correction of reporting later found to be inaccurate, and fair opportunity to reply to inaccuracies “when reasonably called for.” But in practice, ethical obligations to maintain patient confidentiality make it difficult for doctors to respond.

    Incensed by what he considered biased and prejudicial newspaper reporting of Professor David Southall's paediatric research, retired engineer Ivor Rowlands complained about the case to the Press Complaints Commission (PCC). “I think the same legislation should apply to newspaper reporting as it does to driving,” he says, “in that [newspapers] should be liable for publishing without due care and attention.” At the least, he says, coverage should “carry the equivalent of a government health warning, with a statement recognising that the doctor is unable to respond.”

    Based on his own experience of being on the receiving end of allegations made by parents who felt that they had been falsely accused of child abuse, Professor Southall feels that the media should ensure balance by obtaining written agreement from the complainants, giving permission for the doctor to speak about the specifics of a case.

    A spokesman for the PCC doubted that this stance would be possible, but admitted the difficulties of doctors not being allowed to reply even if given the opportunity to do so. He added: “Currently doctors are not ‘special cases,’ but whether they should be is a very, very difficult question.” Representations to the PCC to amend the code of practice would be considered, he said.

    There is no obligation on newspapers to be impartial, but a spokesperson for the Independent Television Commission (ITC) says that this is required of broadcast material. To circumvent the confidentiality issue, she suggests: “Doctors may need to think laterally. They can be helpful without compromising the details of a particular case.”

    Should the media get written permission from the complainants for the doctor to speak about a case?

    The MDU believes that the media have demonised individual doctors. Although it does not condone secrecy, spokesman Dr Peter Schutte thinks that the GMC could help stop doctors' reputations being undermined well in advance of any investigation by refusing to publicise “problem doctors” on its website until just before their case is due to be heard, and not using such a pejorative term for those not yet found guilty of misconduct.

    But Bob Satchwell, director of the Society of Editors, feels that people recognise that stories about “bad” doctors are not the norm, and that they deserve greater credit for their intelligence. BMA polls consistently show that doctors remain the most publicly trusted professionals.

    “Publicity is a safety valve,” says Mr Satchwell. “People would feel it was a whitewash if doctors were given greater protection, because the perception is that they have enough powerful allies already and that they ‘get away with it.’ The media would cite Bristol where it took years to get justice.”

    Arnold Simanovitz, chief executive of the Association of Victims of Medical Accidents (AVMA), says: “The answer is: the disasters should not be happening. If we want to change media reporting, we need to change the culture. Shipman was an exception, but Bristol is not, in our experience. Despite their duty of conduct, we don't get the impression that doctors are being encouraged to say sorry.”

    A spokesperson for Alexander Harris, a leading health litigation firm, says: “When our clients take their cases to the media, it's not to be vindictive, but to prevent the same situation happening again. They have tried the complaints procedure and struggled, and feel the only option left is the media. All they usually want is to know what happened, and an apology.”

    But it's not only patients that might want to register discontent in the media. It recently came to the attention of the BMA that ministers were briefing journalists behind the scenes to the effect that the profession needed taking to task. The final flourish seems to have been Alder Hey, after which the practice was curtailed.