[What happens behind closed doors when physicians become problems? Informal mechanism revealed in a case study]

Problem doctors are a heterogeneous group, and it is sometimes difficult to determine whether a doctor is incompetent or simply makes repeated mistakes hard to avoid completely under pressure of the clinical work-load. The profession has a small repertoire of informal methods for dealing with situations where a colleague has become a problem. An interview study, carried out in Britain and Sweden, revealed the approaches most commonly used. It also showed that the problem doctor's colleagues often hesitate too long in taking the informal approach that the problem is much more difficult to resolve by the time department heads and administrators become involved.