CRITICISM OR JOUSTING OF ONE DOCTOR OF ANOTHER DOCTOR BEFORE PATIENT

Prof .DRRAM,HIV /AIDS,HEPATITIS ,SEX DISEASES & WEAKNESS expert,New Delhi,India, profdrram@gmail.com,+917838059592,+919832025033,ON WHATSAPP

Jousting or Criticising a Doctor by another Doctor to a patient is very common practice among doctors. There are many situations in which doctors can get entrapped in jousting or criticism. The following are some commonly noticed situations where jousting or  criticism is most likely to occur.        Mostly it is practised  when a patient comes to one for a second opinion or specialist advice or for an alternative/complementary form of treatment. Such visits are often misused to vent one’s individual bias about the competence of other practitioners or schools of treatment.Such Doctor should reserve such comments for professional discussions in academic fora. The patient has come  to get the best advice. Please Do not give him the worst of our profession — the habit of criticising others. This will only result in the patient losing faith in the profession beside a point for establishing medical negligence and a court proceedings .                If there is a difference of opinion over the diagnosis, or when the patient has been referred by a general practitioner to a specialist, Specialist should not criticise the other professional to establish superiority. The patient has been referred to senior  because he is  believed to be more competent in that subject.One should  Desist from using patient as a medium to spread criticism of fellow professionals.When our patient sees another doctor during an emergency, or because if one is  otherwise not available, please do not criticise the other professional’s decisions. Rathr this doctor should be thankful to the emergency doctor for having taken care of patient in his absence.            One can be called to express one’s views about a colleague or subordinate during the course of a medical audit, or in a professional enquiry in a medical board or because of a consumer complaint. During a peer review procedure — editing a manuscript, conducting post examinations — one can be tempted to make comments on one’s colleagues. The doctor must take due care to express the opinion confidentially, without a confrontationist attitude, and in a way that does not malign the colleague. The purpose of expressing one’s opinion is to correct the problem, not enter into an enmity.       An honest comment offered in good faith, to promote the patient’s best interests, may be justifiable. However, even this can become inappropriate criticism. Think before you speak out loud. Think again before writing such reports, ask a friend to review what you intend to report in writing to save yourself from inadvertent criticism. Remember, comments which are gratuitous, unsustainable and aim at undermining trust in a colleague’s knowledge or skill are unethical.            Positive criticism can be made in an environment which invites criticism, when doctors seek peer review, when professional associations appoint ombudsmen — all with the intention of analysing current medical practice and using people’s suggestions for self improvement. Even medical council of india states that jousting  is not allowed under MCI Code of Medical Ethics Regulations 4.2, 4.3, 4.4. “4.2 Conduct in consultation: In consultations, no insincerity, rivalry or envy should be indulged in. All due respect should be observed towards the physician in-charge of the case and no statement or remark be made, which would impair the confidence reposed in him. For this purpose no discussion should be carried on in the presence of the patient or his representatives. 4.3 Consultant not to take charge of the case: When a physician has been called for consultation, the Consultant should normally not take charge of the case, especially on the solicitation of the patient or friends. The Consultant shall not criticise the referring physician. He/she shall discuss the diagnosis treatment plan with the referring physician. 4.4 Appointment of substitute: Whenever a physician requests another physician to attend his patients during his temporary absence from his practice, professional courtesy requires the acceptance of such appointment only when he has the capacity to discharge the additional responsibility along with his/her other duties. The physician acting under such an appointment should give the utmost consideration to the interests and reputation of the absent physician and all such patients should be restored to the care of the latter upon his/her return.” Comments:The referring doctor must be respected.The referring doctor must not be criticized. The Substitute or Consulting Physician should not take over the case.