Doctors fearful of reporting colleagues

ONE in three UK doctors not reporting underperforming colleagues avoids doing so out of fear of retribution, a survey has found.

Almost one in five UK doctors has had direct experience of an incompetent or poorly performing colleague in the past three years. And while three-quarters of that number said they raised the alarm, the nearly one third of those who did not gave fear of retribution as the reason for not doing so and a quarter said they thought someone else was taking care of the problem.

The findings were highlighted in a survey of professional values published online in BMJ Quality and Safety. Researchers spoke to more than 1,000 UK doctors working in primary care and hospital medicine and almost 2,000 of their US peers in 2009 about various aspects of professional behaviour. Topics included quality and safety issues, conflicts of interest, and attitudes to patients. Almost two thirds of US doctors and four out of 10 UK doctors responded.

The survey revealed only eight out of 10 respondents in both countries strongly agreed that patient welfare should come before their own financial interests. And only around six out of 10 felt that they should disclose any financial relationships they had with pharma companies to their patients. Most respondents had received gifts or samples from these companies.

Not all doctors agreed that it was “never appropriate” to have a sexual relationship with a patient. When it came to the quality of their own performance, twice as many US as UK doctors agreed that periodic recertification (revalidation) was necessary. But only just over half of US doctors agreed with this, despite recertification having been in place for several years in the US. Revalidation for UK doctors is due to start in 2012.

Researchers concluded: “Especially at times of major healthcare reform, as both the USA and UK currently face, doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour.”