Intended for healthcare professionals

Rapid response to:

Observations Ethics Man

Grandmasters of medicine

BMJ 2019; 366 doi: (Published 20 August 2019) Cite this as: BMJ 2019;366:l5207

Rapid Response:

Re: Grandmasters of medicine

Sokol compares chess play particularly that of grandmasters to the practice of medicine, saying that grandmasters in medicine seek ways to make things even a little better when there is no clear path to improve the situation.

The problem with the analogy is that chess players have to make a move after the opponent has played. One of the skills in medicine is learning to do nothing when no obvious good can be done while explaining and involving patients in that decision. The principle of primum non nocere is relevant here. As Sokol points out it is usually easy to make things worse. Minor improvements may be possible and useful but we should also recognise the benefit of inactivity.

Dr Tim Owen

Competing interests: No competing interests

13 October 2019
Tim Owen
Retired GP