Appeals for information, transparency, and openness are the focus of three articles recently published in The BMJ. From breast cancer screening leaflets to media reporting and medical training, it seems that a lack of openness threatens to harm patient care.
Gerd Gigerenzer warns that current breast cancer screening pamphlets do not provide the information that women need to make informed decisions about their health. He argues that all pamphlets should carry a “fact box” explaining the benefits and harms of breast cancer screening in a transparent way. “I call on all women and women’s organisations to tear up the pink ribbons and campaign for honest information,” he says. “Only by correcting the current misinformation . . . will women be in a position to make informed decisions.”
Meg Carter lambasts the media for their lack of transparency with audiences about the potential conflicts of interest of the people they interview for comments on news developments. She turns a spotlight on the impression given by the media that think tanks provide a balanced view free from influence from their funders, and points to the requirement for broadcasters to work within impartiality guidelines. She asks, “Why, then, do lobbyists and think tanks get so much media space, and why aren’t their vested interests always made clear?”
Jonathan Glass calls for some honest and open reflection on the impact that competency based training is having on doctors’ training. He argues that this tick box approach distracts doctors from learning how to care for patients. “The process suppresses quality in medical students and discourages their personal development when the student is encouraged not to seek wider experience, but simply to fill a book with signatures,” he says. “A tick box form or booklet, together with an incorrect focus on the hours a doctor has worked rather than a system encouraging a true focus on the care of the patient, will never develop the best quality doctors for the future of our nation.”
If patients and the public are not given the information they need to make informed decisions, and doctors do not reflect openly on the training of their successors, patient care will suffer. In all these matters, doctors, patients, and the public need to do some clear thinking. But, first and foremost, we need some information, provided in a transparent and open way, on which to base our thinking.
Tom Moberly is careers editor for The BMJ.