Angry Doctor

Saturday, January 24, 2009

To write is to sit in judgement on oneself

A comment on the previous post on the issue of "decorum" set angry doc thinking about his blogging.

As a young doctor angry doc was taught never to "run down" (yes, that was the exact term used) another doctor in public. The Singapore Medical Council's Ethical Guidelines advises that:

"A doctor shall refrain from making gratuitous and unsustainable comments which, whether expressly or by implication, set out to undermine the trust in a professional colleague’s knowledge or skills."

It seems to angry doc that the SMC's position is more enlightened than the "you don't talk about the Fight Club" rule he grew up with - one should be allowed to criticise if one can substantiate one's criticism, and if the primary aim is not to undermine a colleague.

Our knowledge is imperfect, our system is imperfect, and we ourselves are imperfect; it is inevitable that healthcare professionals will notice when things fail or go wrong, and it is unrealistic to expect them to not speak up while requiring them to provide safe and high-quality patient care. The question then is what setting, what platform should a doctor utilise to voice his or her concerns?

Prof Lee chooses the print media as her platform, and angry doc has chosen a blog.

There are literally hundreds of topics angry doc can blog on, so how does he decide what he blogs on?

angry doc thought about it last night, and he concluded that he writes about things that:

1. He is interested in. Of course; why bother otherwise?

2. He can substantiate. Rants and opinions aside, angry doc tries to gather information and check his facts before he writes on a topic, and he invites readers to correct him where he is wrong.

3. He can get away with. The point that the commenter alluded to at the beginning of the post made, angry doc believes, is that Prof Lee may be able to get away with saying certain things when others may not. angry doc doesn't know if Prof Lee can get away with it, but he certainly thinks there are topics which he cannot get away with criticising.

So at the end of the day, angry doc may be better judged on what he doesn't blog about, rather than what he does blog about.

Maybe.

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posted by angry doc at 6:00 pm

4 Comments:

  • I wonder what would happen if someone were to make a complaint to the SMC ethics committee?

    By Blogger Gerald Tan, At January 25, 2009 12:03 am  

  • Personally I see quite a bit of "not-so-correct" dentistry done on my patients and its a real troubling thing to do nothing for the sake of not "speaking ill" of another person. It's a bit sad too cos you know that same dentist will do the same thing again and again without knowing he/she is wrong.

    By Anonymous Anonymous, At January 25, 2009 12:26 am  

  • That will be an interesting scenario, Gerald.

    Here's what I think:

    First of all we must consider if what Prof Lee did amounted to "improper act or conduct which brings disrepute to [her] profession".

    Secondly, even if what she did "undermined the trust" in our medical system, the basic fact, as she stated in a follow-up letter on Today, was "as accurate as was possible given the circumstances."

    (http://www.todayonline.com/articles/298547.asp)

    Now in a court of law "truth is an absolute defence" (or so I understand), but of course the SMC Disciplinary Committee is not a court of law (at least not yet).

    Even in the case that a complaint is filed (and it must be filed by someone since the SMC cannot on its own initiative file a complaint) and a DC is convevned and Prof Lee is found 'guilty', she may still file an appeal to the High Court, which of course being an open court will turn the whole thing into a media circus.

    So the question is: is the SMC feeling lucky? :)

    By Blogger angry doc, At January 25, 2009 12:51 am  

  • Edgar,

    I think on a 'personal' level we tend to give the 'guilty party' the benefit of the doubt because we know we do not possess all the facts of the case and our judgement may be off - the doctor/dentist may be doing their best given the circumstances, and the patient may not be giving the full or correct information required to pass judgement.

    In Prof Lee's case we are looking at a 'systems' level issue, and one which there is sufficient evidence (although perhaps not local evidence) to make a judgement on.

    Like I said it will be interesting to see how this pans out; the last time somone tried to buy a kidney illegally we ended up moving to legalise organ sale... maybe we will in the future be legally-bound to blow the whistle?

    By Blogger angry doc, At January 25, 2009 12:59 am  

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