Doctors' gossip habits revealed

Doctors discuss cases as they move between wards

Health staff gossip about patient's cases in the lifts at work, a study has found.

Canadian researchers listened in to lift conversations at a Toronto hospital and found confidentiality was breached during one in 10 journeys.

Writing in the British Medical Journal, they say patient confidence is undermined by the practice.

But UK doctors say, while doctors do discuss patients, they never do so by name and it is not disrespectful.

People tell each other funny stories as a release Dr Adam Fox, Royal Free Hospital

Medical students at St Michael's Hospital in Toronto recorded the date, time, duration, and location of every journey they took in a public lift at the hospital during two weeks in November 2002.

They recorded any remarks made by hospital staff which they felt breached patients' confidentiality and any reactions by others in the lift to the comments.

They overheard 18 comments deemed to compromise a patients' confidentiality on 13 out of 113 lift journeys.

Doctors made 11 of the 18 comments, six were made by professions allied to medicine - such as speech or occupational therapists, and one was made by a nurse.

Patients' names were used on four occasions.

'Very careful'

Writing in the BMJ, the researchers, led by Dr Simone Vigod, said: "Breaches of a patient's confidentiality compromise ethical health care and undermine patients' confidence in caregivers, say the authors.

"Clarification of what constitutes a breach in patient confidentiality is needed and healthcare institutions must provide effective training to minimise these breaches."

Dr Adam Fox, a paediatric gastroenterologist at the Royal Free Hospital in London, said he had never heard doctors using patients' names when they were discussing their cases.

But he said it was natural for doctors to talk about funny stories they had heard - or discuss unusual cases as they were moving between wards.

He told BBC News Online: "I think people are very careful. If they are going to have a conversation in lifts. In seven years I've never overheard a conversation where I could identify a patient who I didn't know.

"But I have heard a lot of gory details."

"Many of the stories were urban myths - such as a patient coming into A&E with something up his bottom."

Dr Fox said patients may think telling stories was disrespectful, but it was simply part of the way doctors coped with their work. "People tell each other funny stories as a release."

He said it helped them deal with serious cases too.

"What are emergency and stressful situations to patients are things that are routine to us. That means we can deal with things calmly.

"Patients might think discussing cases is disrespectful, but it's not."