It is very disheartening to hear how NHS staff are able to cover their errors and harass the whistle-blowers,<1> while junior doctors are instructed to honestly document and reflect on their mistakes.<2> This double standard is not unique to only a certain NHS trust. The BMJ reported incidents concerning the lack of transparency about complaints raised in other NHS trusts.<3-5>. Nevertheless, junior doctors’ whistle-blowing could lead to their careers being destroyed by their employers.<6>
There has been ongoing debate on whether junior doctors' documented reflections could be used against them in court.<7> Furthermore, supervisors have the privilege to use the juniors' documented reflections to cover themselves in disciplinary investigations.<2> This blame culture must sound incredibly frightening to many junior doctors.
I wholeheartedly agree that junior doctors should be honest about their mistakes, but it is equally important that other NHS staff are doing the same. How can people convincingly tell the juniors to be honest, when they are not being credible role models themselves? This double standard would certainly further discourage junior doctors to act responsibly for their deeds.
References:
1. Iacobucci G. Review condemns treatment of trust staff who blew whistle on poor care. BMJ. 2018;360:k653.
2. Dyer C, Cohen D. How should doctors use e-portfolios in the wake of the Bawa-Garba case? BMJ. 2018;360:k572.
3. Dyer C. Health watchdog to look again at reports on maternity services at Morecambe Bay trust. BMJ. 2013;346:f4017.
4. Dyer C. Morecambe Bay trust is criticised for lack of openness about complaints. BMJ. 2014;348:g1860.
5. Dyer C. Francis report recommends a whistleblowing guardian in every NHS organisation. BMJ. 2015;350:h828.
6. Dyer C. Case of whistleblower whose career was "destroyed" prompts review of law. BMJ. 2016;353:i2910.
7. Humm GL, Sutton P, Gokani V, Mohan H. Association of Surgeons in Training responds to GMC erasure case. BMJ. 2018;360:k224.
Competing interests:
I have received salaries from working as a medical doctor, but I am not paid to write this letter.
Rapid Response:
Are honest reflections for junior doctors only?
It is very disheartening to hear how NHS staff are able to cover their errors and harass the whistle-blowers,<1> while junior doctors are instructed to honestly document and reflect on their mistakes.<2> This double standard is not unique to only a certain NHS trust. The BMJ reported incidents concerning the lack of transparency about complaints raised in other NHS trusts.<3-5>. Nevertheless, junior doctors’ whistle-blowing could lead to their careers being destroyed by their employers.<6>
There has been ongoing debate on whether junior doctors' documented reflections could be used against them in court.<7> Furthermore, supervisors have the privilege to use the juniors' documented reflections to cover themselves in disciplinary investigations.<2> This blame culture must sound incredibly frightening to many junior doctors.
I wholeheartedly agree that junior doctors should be honest about their mistakes, but it is equally important that other NHS staff are doing the same. How can people convincingly tell the juniors to be honest, when they are not being credible role models themselves? This double standard would certainly further discourage junior doctors to act responsibly for their deeds.
References:
1. Iacobucci G. Review condemns treatment of trust staff who blew whistle on poor care. BMJ. 2018;360:k653.
2. Dyer C, Cohen D. How should doctors use e-portfolios in the wake of the Bawa-Garba case? BMJ. 2018;360:k572.
3. Dyer C. Health watchdog to look again at reports on maternity services at Morecambe Bay trust. BMJ. 2013;346:f4017.
4. Dyer C. Morecambe Bay trust is criticised for lack of openness about complaints. BMJ. 2014;348:g1860.
5. Dyer C. Francis report recommends a whistleblowing guardian in every NHS organisation. BMJ. 2015;350:h828.
6. Dyer C. Case of whistleblower whose career was "destroyed" prompts review of law. BMJ. 2016;353:i2910.
7. Humm GL, Sutton P, Gokani V, Mohan H. Association of Surgeons in Training responds to GMC erasure case. BMJ. 2018;360:k224.
Competing interests: I have received salaries from working as a medical doctor, but I am not paid to write this letter.