Intended for healthcare professionals


Suspension of doctors

BMJ 2004; 328 doi: (Published 18 March 2004) Cite this as: BMJ 2004;328:709

Medical suspensions may have ideological nature

  1. D B Double, consultant psychiatrist (dbdouble{at}
  1. Norfolk Mental Health Care NHS Trust, Norwich NR6 5BE

    EDITOR—Like Empey, I welcome the new guidance and directions from the Department of Health on the suspension of doctors.1 I was suspended for six months by my NHS trust, from October 2000, before the National Clinical Assessment Authority (NCAA) was established, and I had to undergo a period of supervision for a year following a recommendation from the Royal College of Psychiatrists.

    According to the National Audit Office I am in the minority of suspended doctors who have returned to work (40%).2 The length of my suspension was below average (47 week average), not least because I went along with the recommendation from the college, even though I did not accept it. As noted by the National Audit Office, concerns exist about the thoroughness and rigour of external assessments.

    My problem is the potential ideological nature of suspensions. Medicine, perhaps particularly psychiatry, is not an exact science. Attitudes and approaches vary from the biomedical to the psychosocial, and biomedical bias is reinforced by defensiveness about the personal nature of medicine.3 Psychiatry especially has been infused by conflict, perhaps best reflected in the debate about so called anti-psychiatry.4

    I was told I needed retraining and would be sent for further education in organic psychiatry. The college assessors indicated that, if I did not accept their recommendation, my philosophy about psychiatry would need to be examined and my scepticism about the use of medication challenged. Although none of these things happened, it is difficult to think they were not motivating factors in my suspension.

    I am not sure if critical psychiatry, which is the position I represent, has been strengthened by my experience. At least, information about critical psychiatry is now available on the Royal College of Psychiatrists' website.5


    • Competing interests None declared.


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