This excellent and timely article, O&G Magazine Vol 15 No 2 Winter 2013, overlooks one important problem: the power imbalance.

In the 1950s, I was a registrar in the UK and for my last 12 months I worked for a consultant who was nearly always affected by alcohol after 6pm. I had become used to taking 99 per cent of the responsibility for after-hours emergencies. One day, at about 2am, I admitted a patient with a rare and life-threatening emergency
in mid-pregnancy. After much argument on the telephone, the consultant came to see her. He was obviously the worse for wear and there was a confrontation.

I had already been successful in obtaining a teaching hospital senior registrar appointment. A few days later, the consultant told me that he would write to Prof X and that would kill my career stone dead! He also refused to sign my book for the MRCOG.

Fortunately, Prof X was a reasonable man and I did not suffer the threatened fate. However, I still feel that sickness in the gut when I remember this incident. In those days, there was no clear procedure in UK hospitals.

It is now well-known that whistle-blowers tend to suffer a negative effect on their careers. I do not know the answer to this problem, but consider that the authorities should bear in mind the power imbalance.