PHYSICIANS ATTITUDES TO THE AUTOPSY

The overall autopsy rate (excluding coroner's autopsies) at a large te aching district general hospital over a four year period was 16.5%, bu t individual rates for ten general physicians varied from 5% to 35%. D uring this period, the mean autopsy rate for general medicine (14%) wa s significantly lower than rates for cardiology (21%), geriatrics (23% ) and paediatrics (36%), but similar to general surgery (13%). Autopsi es were widely perceived as being of benefit to education and research , but physicians were often unaware of their value for confirming the diagnosis and for clinical audit, and over-estimated their actual auto psy rates on average by 50%. High rates (18-30%) were associated with consultants who had a definite policy regarding autopsies and had made this clear to their junior staff. Low rates (6-10%) obtained where th ere was no consultant policy on autopsies, and were frequently attribu ted by the consultant physicians to failure by their junior staff. Phy sicians should be more aware of the value of autopsies, and should tak e responsibility for increasing and monitoring autopsy requests to imp rove clinical audit, quality assurance and medical education.