Intended for healthcare professionals


Doctors and managers

BMJ 2003; 326 doi: (Published 18 January 2003) Cite this as: BMJ 2003;326:116

A constructive dialogue has to replace mutual suspicion

  1. Nigel Edwards (, policy director,
  2. Martin Marshall, professor of general practice
  1. NHS Confederation, 1 Warwick Row, London SW1E 5ER
  2. National Primary Care Research and Development Centre, University of Manchester, Oxford Road, Manchester M13 9PL

    The rejection of the contract for UK consultants has brought the relationship between doctors and managers into sharp focus. The BMA and consultants got a bad press. Managers were characterised as everything from the unwilling pawns of a malign government to intellectually second rate, morally bankrupt outsiders who do not understand health care and exist only to frustrate good patient care. This caricature of doctors fighting with managers is strange as many of the managers who would have been responsible for implementing the contract were in fact doctors. Some serious work by managers and doctors is needed to understand the nature of the problem and develop new ways of working together.

    It is helpful to see this latest upset as part of a deeper problem, which has a long history. …

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