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 Table of Contents  
LETTER TO THE EDITOR
Year : 2020  |  Volume : 25  |  Issue : 1  |  Page : 50-51

Medical jousting: Think well before speaking


1 Department of Forensic Medicine and Toxicology, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
2 Department of Pharmacology, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India

Date of Submission26-Sep-2019
Date of Acceptance09-Jan-2020
Date of Web Publication14-Apr-2020

Correspondence Address:
Dr. Vijay Thawani
Department of Pharmacology, People's College of Medical Sciences and Research Centre, Bhopal - 462 037, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmgims.jmgims_63_19

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How to cite this article:
Agrawal A, Thawani V. Medical jousting: Think well before speaking. J Mahatma Gandhi Inst Med Sci 2020;25:50-1

How to cite this URL:
Agrawal A, Thawani V. Medical jousting: Think well before speaking. J Mahatma Gandhi Inst Med Sci [serial online] 2020 [cited 2020 May 25];25:50-1. Available from: http://www.jmgims.co.in/text.asp?2020/25/1/50/282363






  What is Medical Jousting? Top


The historical meaning of jousting is to be engaged in a sporting contest in which two opponents on horseback fight with lances.[1]

In modern times, making derogatory remarks on a coworker/colleague is called jousting. When such comment/criticism is made by a medical professional on the work/treatment of another doctor, it is termed as medical jousting.


  Why and by Whom is it Practiced? Top


In a common scenario, it is practiced by some doctors out of jealously against fellow colleagues in profession. It is usually done when the other doctor has more patients or the doctor who is making such comments has feeble knowledge about the field of other doctor. It is often seen that the practitioners of different streams/fields criticize the work of others because their intervention/modality of treatment is different.


  How is it Practiced? Top


Medical jousting can be done by just making a statement which raises any type of question on the skill, efficiency, or efficacy of another practitioner. Comments like:

  • Why the X-rays were not taken?
  • Why the blood work and other investigations were not done?
  • Did the doctor examine the patient thoroughly?
  • Did the surgery go well?
  • Why the particular type of anesthesia/procedure was done and not the alternative?
  • Did the attending doctor take a second opinion before initiating the treatment?
  • Was the doctor sure of his diagnosis and treatment?[2]
  • If you had come to me first, I would not have treated like this.
  • Your case has been spoilt; nothing can be done now.
  • Who gave you this scar? This could've been avoided![3]


Such expressions constitute medical jousting.


  When and Where is it Practiced? Top


Jousting is done by any doctor at his own clinic or hospital in front of patients or attenders or other colleagues.

Making a journal review, reference, or comparison from the work of another practitioner is allowed, but sheer criticism with intention of showing the other person down, using derogatory/filthy language, is not acceptable. Similarly, the “yellow journalism” is not welcome. When criticizing or noting down a fault in other person's work, the critic should be doubly sure and should check the background limitations and all other aspects of the study very carefully before indulging in criticism. The criticism should be healthy and the tone and tenor of language should be respectable.


  Repercussions of Medical Jousting Top


If a case of jousting is noticed, it can be brought into the notice of the head of department/institution. The person if found guilty could be reprimanded and left with warning or may be restricted from department/institution for a considerable amount of time. The Medical Council of India states that what amounts to jousting is not allowed in the Medical Code of Ethics Regulations. Section 4.2 relates to conduct in consultation which states that in consultations, no insincerity, rivalry, or envy should be indulged. All due respect should be observed toward the physician in-charge of the patient and no statement or remark be made, which would impair the confidence reposed in him. For this purpose, no discussion should be carried in the presence of the patient or his representative.[4]

By passing any such comments, the one who is criticizing may land up in legal hassles if such comments are recorded and made viral or used in the court as evidence.


  Prevention Top


Taking in consideration the Declaration of Geneva, every colleague should be considered as brother or sister and no enmity or jealousy should be kept for any fellow colleague.[5] If a reference is made for a patient who received primary treatment from another physician and if at all any incompetency is found, it should better not be mentioned to the patient or attender and if very important, it can be discussed by the physician in-charge personally. Discuss the problem/complication with the patient in a way that it should not be offending for another physician. Avoid making any personal or professional comment for any fellow colleague regarding any case in front of any outsider/nonmedico population.

Medical jousting may add onto the incidents of violence against the doctors and may worsen the situation for the medical practitioners all over the country. Medical jousting wittingly or unwittingly exists. It appears to be on increase. This is an avoidable and unnecessary evil encompassing clinical practice. Medical doctors should refrain from criticizing their colleagues in front of patients and their attendants in the interest of the medical profession. They should be united and support each other.[6] Better that the medical professionals desist from medical jousting.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Cambridge Dictionary. Available from: https://dictionary.cambridge.org/dictionary/english/joust. [Last accessed on 2019 Sep 24].  Back to cited text no. 1
    
2.
Ashok DS. Medical Jousting: The no win conundrum for everyone. J Edu Res Med Teach 2017;5:30-2.  Back to cited text no. 2
    
3.
Rawat S. Avoid Medical Jousting Please. DHRC e-Connect. Dharamshila Hospital; February, 2017. Available from: http://www.dhrc.in/downloads/DHRC-Newsletter-Feb-2017.pdf. [Last accessed on 2019 Sept 25].  Back to cited text no. 3
    
4.
Medical Council of India. Code of Medical Ethics. https://www.mciindia.org/documents/rulesAndRegulations/Ethics%20Regulations-2002.pdf Page 6. 19. [Last accessed on 2019 Sep 24].  Back to cited text no. 4
    
5.
Praveen G, Akkaloori A. The revised Declaration of Geneva, 2017, and India's contradictory legal provisions. Indian J Med Ethics 2018;3:254.  Back to cited text no. 5
    
6.
Subrahmanyam BV, Veera Nagi Reddy G, Phanindra SV, Subba Rao KS. Medical jousting: Ethical and legal implications. Narayana Med J 2017;6:68-70. Available from: https://www.ejmanager.com/mnstemps/69/69-1497600639.pdf?t=1569383487. [Last accessed on 2019 Sep 25].  Back to cited text no. 6
    




 

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