WHAT makes doctors “go bad”? That’s the question posed by Health Service Journal (Jan 18) above a news item about research into poor performance.

The research, believed to be the first of its kind, examines what makes some doctors “difficult characters”. Using interviews and psychometric data, it looks at the personalities of hospital doctors and GPs referred to the National Clinical Assessment Service, an NHS organisation that supports those whose performance raises concerns.

The study finds that communication problems are common among those referred. Dr Jenny King, the lead researcher, says that they may also be seen as emotionally volatile, narcissistic or arrogant.

“They can be extremely difficult to please and have poor self-awareness. They may be intellectually intelligent, but not emotionally.”

The good news is that occupational psychologists can provide remedial support.

From bad doctors to bad nurses, and a report in Nursing Times (Jan 16) that examines the negative impact on patients of nurses who appear not to care. A study finds that nurses who lack empathy diminish patients’ confidence and compliance with treatment. It also showed that patients were more fearful, confused and depressed in situations where nurses were felt not to have shown empathy.

Mark Radcliffe, an NT columnist, says that everyone knows that some nurses are not as good as others, but that admitting as much makes people defensive. “We need to be able to recognise poor practice and not ignore it or excuse it.”

Nursing Standard (Jan 17) suggests that nowadays fewer patients are prepared to excuse poor practice. Complaints about nurses from patients and families are on the rise, and will soon outstrip those from employers, lawyers say.

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