The indictment of medicine

David Sellu recently gave an interview to the Royal Society of Medicine. It was based on his book Did he save lives? A surgeon’s story. I have mentioned him in a previous post. 

His story is an indictment of the state that clinical governance in medicine has created. As I said in my BMJ letter, the increasing regulation of doctors has created a climate of fear and a culture of defensive practice. Over-reaction in investigation reports may lead to naming, blaming and shaming for what is presumed to be incompetence, carelessness or recklessness. But reports are not immune from mistakes and do not always deserve the authority given to them. Clinical errors occur and actually do not always detract from safety (see previous post). Clinicians live with uncertainty and have to act in the real world. 

Judgement about clinical behaviour needs to be fair and open. Even the legal system did not protect David Sellu, although it did eventually exonerate him on appeal. Medicine and surgery are in a precarious state when a decent and competent surgeon can wrongly be found guilty of manslaughter. Medicine needs to stop pretending that clinical practice is always objective and build on its professionalism and experience.