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Matters Arising

Misleading title

Padraic J Grattan-Smith
MJA 2006; 185 (11/12): 674

To the Editor: I would like to comment on two articles that appeared recently in the MJA.

“Doctors behaving badly?”1 was an anticlimax. It was not, as would be expected, an exposure of misconduct by doctors, but dealt with the potential conflict of interest that occurs when they interact with the pharmaceutical industry. No evidence of doctors “behaving badly” was provided, yet a solution to this potential problem was proposed — “disclosure” (ie, yet more paperwork), accompanied by a disclaimer that this was unlikely to work.

This is an important issue, but the content of the article cannot justify such a misleading title. I can only assume it was the result of editorial intervention, in which case there is some hypocrisy at work, given that the inside front cover and the outside back cover of the same issue of the Journal are taken up with full-page drug advertisements, and within, a $10 000 prize was offered for the best original research article published in the Journal (sponsored by a drug company).

The second article, From the Editor’s Desk “Tilting at titles”,2 which cited the dreaded Australian values, suggested that titles such as “doctor” should be trashed altogether and replaced by an introduction such as “Hello. I’m Jean Smith. I am a urologist and together we will confront your prostate problem” — a statement that is unlikely to give great confidence to the average digger.

Doctor Samuel Johnson put this argument to rest in 1775:3

What is implied by the term Doctor is well known. It distinguishes him to whom it was granted, as a man who has attained such knowledge of his profession as qualifies him to instruct others. A Doctor of Law is a man who can form lawyers by his precepts. A Doctor of Medicine is a man who can teach the art of curing diseases.

My concern is that there appears to be an editorial assumption that doctors are preoccupied with titles and are willing to treat patients unethically for a few glasses of Kooyong Pinot Noir and a good feed. This might be good press, but not in the MJA. Perhaps some disclosure is required.

To return to Johnson:

There are but two reasons for which a physician can decline the title of Doctor of Medicine, because he supposes himself disgraced by the doctorship, or supposes the doctorship disgraced by himself.

Padraic J Grattan-Smith, Paediatric Neurologist

Sydney Children's Hospital, Sydney, NSW.

padraic.grattan-smithATsesiahs.health.nsw.gov.au

  1. Tattersall MHN, Kerridge IH. Doctors behaving badly [editorial]? Med J Aust 2006; 185: 299-300. <eMJA full text> <PubMed>
  2. Van Der Weyden M. From the Editor’s desk: tilting at titles. Med J Aust 2006; 185: 297. <eMJA full text>
  3. Boswell J. Life of Johnson. Oxford: Oxford University Press, reprinted 1987: 632-633.

(Received 28 Sep 2006, accepted 26 Oct 2006)

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