I woke up this morning feeling uneasy. I had been dreaming about those poor souls who were unfortunate enough to have PIP implants in the private sector and now feel abandoned and confused. Conflicting messages from the media about the relative risk, help offered in one country and not another and the shuffling of responsibility has heightened the distress possibly more than necessary.

My uneasiness is borne out of being a doctor and the collective guilt we feel as a profession when patients are disappointed with the level of care or, more importantly, the level of caring they perceive. Whose fault is it? Well let’s get one thing straight. It is not the patient’s fault, no matter what glib and often disparaging comments about vanity and ‘serves them right attitude’ you may hear from those with a poor understanding of the reasons why people undergo this type of surgery.

I can understand the anger some of my colleagues feel towards the authorities for allowing CE mark approval for the device. As medics we will ask what due diligence did our colleagues undertake to satisfy themselves independently that these implants were fit for purpose and had the device fulfilled legitimate criteria elsewhere such as in the US. I can understand the anger the authorities feel towards the manufacturer and in turn ask what due diligence did they undertake to ensure safety criteria were meet. No doubt litigation will follow along these channels.

But what about the patients. As a doctor there is one overriding contract with the patient and that is the ‘duty of care’. That care should be without prejudice to finance, which is merely a tool we employ to allow us to live and practice medicine. We carry insurance demanded by the regulator so that, when we err, patients can be compensated and helped to cope with life after the event. In the case of PIP, even though there may be a legitimate onward claim against the regulator, in the absence of insurance we still have a duty of care to restore and protect the health of the patient to the best of our ability. No matter how hard it is to swallow, money should have nothing to do with it.

Most patients love their doctors and often with good cause. They praise us when all is going well and we enjoy their goodwill whether truly deserved or not. It is when things go wrong that’s when you really get to know the person. I am proud of my colleagues who have stepped up to the mark but regrettably it is not universal.

The next time you consider treatment perhaps you should include in your checklist; ‘’ how do you manage your mistakes?’’

And believe me we all make them!