Chris Lancelot on...the profession’s black sheep

Every profession has its black sheep: ours is no exception. We all know them — the GP you wouldn’t register your relatives with; the surgeon you’d never consult.

The public also knows about failing doctors, but in a more nebulous way. Some of their concerns are due to the misunderstanding of risk or the nature of medicine itself — but some of their criticisms are valid. How should the profession respond? The public constantly accuse us of closing ranks to protect our colleagues, and they are right. It doesn’t happen as often as they think, but it certainly occurs.

Historically, identifying and removing poor-quality doctors has been hindered by a huge attitude problem within the profession — a perpetuation of the schoolboy ethos of ‘never rat on your friends’. Indeed, until relatively recently GMC regulations stated that if you criticised a colleague publicly, you could yourself be charged with bringing the profession into disrepute.

Times have changed: each of us now has a duty to report any doctor whom we suspect might be incompetent. But old attitudes run deep: when was the last time you reported someone?

Now I don’t want to appear uncaring or judgmental over colleagues whose lives have gone sour: those who are addicted, depressed, stressed or just out of their depth. There’s a human being behind each of these sad stories who needs dealing with gently and supportively.

Other failing doctors are more selfish: over-confident, greedy, lazy or fraudulent. But whatever the reason we cannot stand by and do nothing.

When GPs consider strike action we worry about ‘letting our patients down’. So why do we allow unsuspecting members of the wider public to risk their health through consulting colleagues we suspect are incompetent? Do we really care about patients as a whole, or only our own ones?

If failing doctors are neither identified properly nor dealt with appropriately, this reduces the level of trust the public will place in the profession in general: they can never be completely certain who is good and who is not.

At some stage we doctors have to grasp the nettle of actively reporting failing colleagues. Once this happens our profession’s standing in the eyes of the public will rise, and their confidence in us as individual practitioners will be enhanced.

Dr Lancelot is a GP from Lancashire. Email him at

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