If you've been the victim of medical error, and you're expecting other doctors to back you up, then think again - they won't. Doctors say they would not report incompetent colleagues, or those whose decisions are impaired through alcohol or illicit drugs, or because they have mental health problems, a new survey reveals. Doctors are often the ones in the front-line who are best placed to notice the incompetence of a colleague, and it is outlined in 'best practice' guidelines that they should do so. So the findings of the survey, carried out by Massachusetts General Hospital, are worrying. In it, around a third of the doctors who responded said they would not report an incompetent, or impaired, colleague. "Our findings cast serious doubt on the ability of medicine to self-regulate with regard to impaired or incompetent physicians," says study team leader Catherine DesRoches. (Source: Journal of the American Medical Association, 2010; 304: 187-193).