Article Text

other Versions

Download PDFPDF
Democratising civility: Commentary on ‘McCullough LB et al: Professional virtue of civility and the responsibilities of medical educators and academic leaders’
  1. Philip A Berry
  1. Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Philip A Berry, Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK; philaberry{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

McCullough and colleagues draw an historical line from the writings of Percival, who found himself resolving arguments (sometimes violent) between physicians, surgeons and apothecaries, to the concept of civility as a professional virtue and duty. The authors show that civility is a prerequisite to effective cooperation, which itself underpins patient safety and positive clinical outcomes—desirable endpoints of any discussion about healthcare. They exhort academic leaders to teach, role model and reward correct behaviours.1

Why then, as a clinician manager with a deep interest in fostering civility and psychological safety, am I not satisfied?

Three reasons: the paper does not adequately explore the reasons why, its focus is largely restricted to academic institutions, and it does not encompass the non-clinical workforce; as a result, its proposed solutions appear ungrounded.

Why are ‘good people’, who were attracted to careers that demand altruism and empathy, uncivil in the workplace? What are the competing goals that result in curt, disrespectful or downright rude exchanges? This has been studied. Leape et al concluded that endogenous factors such as personality, insecurity, anxiety, depression, narcissism and responses to prior …

View Full Text


  • Twitter @philaberry

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Linked Articles