In 2004, I presented a poster of my musings on my professional experiences as a radiologist at the hands of medical colleagues. While I felt very strongly about its contents, I thought it would provide a little amusement among the scientific works at the meeting of the Royal Australian and New Zealand College of Radiologists. To my amazement, it struck a chord with many delegates — obviously, I was not alone in seething about discourtesy, which seemed rife, between professional colleagues.

Most doctors (and their medical indemnity organisations) agree that patient rudeness and aggression are an increasing problem, and there is discussion on strategies to deal with these. Insufficiently debated is what I believe to be an increasing trend to discourtesy between referring clinicians and radiologists and between radiological colleagues.

There are international and Australian codes of ethics regarding behaviour between colleagues.1-3 However, my literature search for references to practical day-to-day courtesy between colleagues revealed mainly concerns as to whether it was polite to bill fellow practitioners for services rendered!4

It would be easy to dismiss interprofessional rudeness as a facet of the decline in good manners in the general community. However, I consider that loss of courtesy between colleagues reduces directly the quality of patient care, and also the enjoyment of one’s working life.

The complexities of modern medicine mean that no one doctor can be a “jack of all trades”. However, a lack of respect for the unique skills of another branch of medicine, and an unwillingness to admit some ignorance of these skills and to request advice, result in behaviour such as the following:

• An x-ray packet was returned to the radiologist with the terse instructions “RE-REPORT” pinned to the packet.

• In a telephone conversation to the radiologist who had reported a normal result on breast ultrasound examination, a general practitioner said “I ordered you to do an FNA [fine needle aspiration] and I expected it to be done. In future, when I order an FNA, it will be done.”

• After requesting a large number of examinations without consulting the radiologist, a country GP wrote: “Do not return patient to . . . until all tests ordered have been performed.”

I sometimes feel that doctors have a desire to appear powerful in the eyes of patients. This may have resulted in the handwritten note from a GP, presented to me one morning (Box 1).

Fear of litigation is always with us, and it is tempting to try to share the blame, but there is no excuse for the following outburst:

• A surgeon opened a telephone conversation to the radiologist with the words “I have told this patient to sue you to hell”.

Colleagues are always going to make mistakes, and one day it is going to be you! One-upmanship is never helpful (Box 2).

Short, friendly, personal letters or phone calls (even in this age of impersonal emails and text messages) are still the better way to point out a colleague’s error. Certainly, a fax received at the reception desk, and available for all to read, causes severe angst in the recipient (Box 3).

And last, but not least, bullying in the playground or the workplace causes untold distress. Remember, you were a junior hospital doctor once!

As a first step towards achieving a more pleasant work environment, the medical colleges should encourage debate on maintaining good manners and professionalism between their fellows.

After that, it’s over to you and me!