Intended for healthcare professionals

Letters Rudeness at work

It’s rude to argue?

BMJ 2010; 341 doi: (Published 10 August 2010) Cite this as: BMJ 2010;341:c4301
  1. D B Double, consultant psychiatrist1
  1. 1Victoria House, Lowestoft NR32 1PL
  1. dbdouble{at}

    Flin describes disagreements and aggression in the operating theatre as though they are the same thing.1 I am not suggesting that scrub nurses should have to tolerate surgeons’ bad temper and tantrums. But her example of two airline pilots becoming engrossed in a heated discussion over airline policy, with no evidence that they were rude to each other, highlights the difference between disagreement and rudeness.

    Abuse, rudeness, and incivility have no place at work. However, this does not mean that disagreements can be eradicated. Her proposal for harmony would suit the command and control style of management that has caused problems in the NHS,2 and would avoid any challenges to it. As the Francis report has recently reinforced,3 staff need to feel confident that they can raise genuine concerns and that these will be taken seriously. Fear of being called rude, or worse, in such circumstances also poses a threat to patient safety and quality of care, as does rudeness itself.


    Cite this as: BMJ 2010;341:c4301


    • Competing interests: None declared.