W.W.H.D. 2

Here’s another one they will never ask during the Final M.B.B.S. MCQ paper.


"You are an orthopaedic surgeon in a restructured hospital.

A young man is scheduled for bone-grafting for non-union of a scaphoid fracture. He asks you for a memo to his company stating that he was referred to your clinic from the polyclinic.

You check his notes. He had in fact presented to the Emergency Department for chronic pain in his wrist a few months after his initial injury, and had been referred to your clinic from there.

You ask him about this discrepancy in his history and he explains that as per his company policy, the company would only pay for his surgery if he was referred to a specialist through a polyclinic, but not the Emergency Department."

What should you do?

A. Be honest
Tell him you cannot provide such a memo.

B. Use a little imagination
Write a memo stating that even though he was not referred to your clinic from the polyclinic, had he gone to a polyclinic, he would have been referred to your clinic.

C. Use a little creativity
Advise him to visit a polyclinic to obtain a referral to your clinic, then provide a memo stating that he had been referred to your clinic from the polyclinic, but leave out the relevant dates in your memo.

D. Lie a little
Write a memo stating that the patient's condition was so urgent that he needed to be seen at the Emergency Department and could not have waited to be seen at a polyclinic.

E. Lie a lot
Write a memo stating that the patient had been referred to your clinic from the polyclinic.


Will your answer differ if his injury was sustained during work? Will your answer differ if his injury was not work-related?

What if he tells you neither option B nor D will carry any weight with his company?

What would Hippocrates do? What would you do?