Doctors are tending to be perceived as inherently bad
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《英国医生杂志》
EDITOR—In his editor's choice Smith describes how doctors are mangled by "justice."1 What's bad is bad, what's wrong is wrong, and wrongdoing has to be recognised and criminality punished. However, criminalisation of doctors seems to be the new way forward in society and increasingly in Europe.
Daily in Italy media reports mention the neologism "malasanità" (the bad health service). Everything is perceived as unhealthy or as not providing rapid answers, and every death that is not "expected" is alleged to have been caused by bad doctors who are unable to work and are looking only for money. Such reporting is destroying the relationship between patients and doctors, especially where it needs to be strong—for example, in primary care.
As a result, doctors will find it hard to maintain enthusiasm for their profession. A recent national survey in general practice showed that two out of three general practitioners are burnt out—and not only because of bureaucracy, paperwork, and pressure from health authorities to cut expenses and control their work. The low point is the progressive deterioration in general practitioners' relationships with patients, who don't trust doctors any more but are confrontational and litigious.
The media continually encourage people to ask more and more and to criticise, implying that the law courts are the place to find real health. In this atmosphere the courts are pushed to see doctors as corrupt and bad.
Defensive medicine is growing. It is rare and dangerous now for a doctor to take the initiative and be responsible for a lot of decisions, indications, small operations, and treatments that used to be the natural way of life of a good general practitioner.
Francesco Carelli, national representative
EURACT Council, Italian College of General Practitioners, 20123 Milan, Italy carfra@tin.it
Competing interests: None declared.
References
Smith R. Doctors mangled by "justice." BMJ 2004;328: 0. (17 January.)
Daily in Italy media reports mention the neologism "malasanità" (the bad health service). Everything is perceived as unhealthy or as not providing rapid answers, and every death that is not "expected" is alleged to have been caused by bad doctors who are unable to work and are looking only for money. Such reporting is destroying the relationship between patients and doctors, especially where it needs to be strong—for example, in primary care.
As a result, doctors will find it hard to maintain enthusiasm for their profession. A recent national survey in general practice showed that two out of three general practitioners are burnt out—and not only because of bureaucracy, paperwork, and pressure from health authorities to cut expenses and control their work. The low point is the progressive deterioration in general practitioners' relationships with patients, who don't trust doctors any more but are confrontational and litigious.
The media continually encourage people to ask more and more and to criticise, implying that the law courts are the place to find real health. In this atmosphere the courts are pushed to see doctors as corrupt and bad.
Defensive medicine is growing. It is rare and dangerous now for a doctor to take the initiative and be responsible for a lot of decisions, indications, small operations, and treatments that used to be the natural way of life of a good general practitioner.
Francesco Carelli, national representative
EURACT Council, Italian College of General Practitioners, 20123 Milan, Italy carfra@tin.it
Competing interests: None declared.
References
Smith R. Doctors mangled by "justice." BMJ 2004;328: 0. (17 January.)