The GMC’s archive of disciplinary cases makes fairly varied reading, but there are a few common themes. The medical herd is constantly being thinned out by drink and drugs, by an exuberant willingness to see patients as potential love interests, and by plain incompetence. An unhappy personal life or an above-average quota of bad luck can sometimes lurk in the background of the story. But one crime, recently committed against a friend of mine, never seems to feature, and I think it should.
What happened in my friend’s case can be summarised in five words: ‘the other doctor missed this’. She hadn’t missed anything. She had seen a patient with a notoriously difficult condition. She had given entirely appropriate care, investigated properly, and safety-netted. Sadly, despite doing everything right, things can still go wrong.
Her patient suddenly worsened later that evening, and was taken to the local emergency department. Tragically, she died there.
The bereaved family, in those first numb and infinitely vulnerable moments, was approached by one of the A&E doctors. In possession of a fully functioning retrospectoscope (though none of the facts), he sat down and told them that my friend had failed to do her job properly. If she had been a better doctor, he suggested, the patient would have lived.
They will never forget that. They will always wonder if more could have been done. It is worth reiterating that this was not whistleblowing. He did not know – or, apparently, care – what she had or had not done. But he did not let that stop him.
It’s difficult to know where to begin. The sheer self-regarding smugness, or the willingness to unleash such destructive power for cheap point-scoring – which should be condemned first?
We have all been in the position where, a little further down the line, time has made things clearer for us than they were for a previous clinician. Most of us realise that this is not because we have superior powers. We are exasperated when the media fail to understand this and accuse a doctor of failing to diagnose something that wasn’t there at the time of consultation. Safety-netting is an inbuilt part of general practice for all of us, for one very simple reason – clinical signs and symptoms evolve with time.
When doctors who should know better score meaningless points at the expense of unknown colleagues, and destroy a family’s peace of mind in the process, we should be more than exasperated. We should be furious. We should demand that they are dealt with as toughly as the perpetrators of any other crime that causes unending and irreparable harm to our patients, their families, and the reputation of our profession.
Dr Nick Ramscar is a GP in Bracknell, Berkshire