Thursday, July 12, 2012

What should a doctor do if he feels another doctor is incompetent ?

Doctors are usually well informed about the professional competency and skills of their colleagues, because they work in the same hospitals and see the same group of patients. Most doctors are aware of which of their colleagues are proficient – and which of them are downright incompetent and dangerous. While doctors are happy to refer their patients to competent colleagues , what do they do when  they know that another doctor within the hospital is incompetent ? This is often an open secret – one of those things which all the professional staff is aware of, but which is carefully hidden from patients.

Most doctors will take an attitude of – It’s really none of my business , so why should I do anything ? My job is to take care of my patients, and I will do just that ! Why should I interfere with someone else’s work ? They pretend not to see any evil, or hear any evil, which is why they will not speak any evil ! ( For example, one of India's busiest IVF clinics is run by a skin specialist - a fact which everyone knows, but does nothing about).

There are multiple reasons for this silence.

Doctors are professional colleagues , and you do not want bad mouth them , because if you are labeled as a whistleblower , you are likely to be ostracized. Equally importantly, there is no easy mechanism by which doctors can point out which of their colleagues are problem doctors. Who do they complain to ? Complaining to the medical council or the hospital administration is difficult and time consuming -  and most busy doctors don't want to poke their nose in some other doctor’s life , or stick their neck out !  The common justification is – Why should I bother ?. I have enough problems of my own to handle , without taking on someone else's ! The fear that your colleagues may disapprove of your actions means that keeping silent is the easiest course , and that's what most doctors tend to do ! If junior doctors see that their seniors are keeping quiet , they believe that this is the standard of behavior which is expected of them , and they model this. The other fear is that if you do bring attention to the fact that a colleague is incompetent, people will think you're doing it because you're jealous , are want to bring down your competition . This is why most doctors turn a blind eye to the incompetence of other doctors.

It's easy to justify this by saying - I'm not my brother’s keeper ! My job is to take good care of my patients, and as long as I'm doing this, why should I bother about what someone else is doing ? It’s this kind of silence which leads to an ever-increasing number of incompetent doctors , who cause a lot of harm to their patients. As a result , the reputation of the entire medical profession takes a beating . The general perception seems to be that the medical profession cannot police itself (or even worse, will not police itself ) as a result of which society is now appointing outsiders (including policemen , bureaucrats and NGOs ) to make sure that doctors toe the line. Sadly, because they are outsiders and do not understand the doctor’s job and the pressures he faces in the daily grind of medical practice, this kind of policing often causes more harm than good.

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