I happened upon a copy of HSJ and, with interest, read the feature about appraisal of consultants ('Getting won over', pages 22-23, 2 August).

I was shocked to see the manner in which the article was written and the accompanying artwork (left) on the front page, which seemed to be calculated to cause offence to consultants.

I had understood that the first principal of appraisal was that it should be entered into without preconceptions.

How then is it that the phrases 'consultants will have an opportunity to moan about the workload' and 'it is possible that some doctors will be able to wriggle out of appraisals this year' can be appropriate use of language?

For appraisal to be a valuable exercise, it must be conducted on an understanding that there will be a two way flow of information, and that all contributions to the process will indeed be given appropriate and reasoned consideration.

All consultants that I have known have cared very much about any inadequacies (including patients being kept waiting) in the service that they provide.

The need to take further time out of clinics, operating sessions and the like to allow for the preparation and conduct of appraisal will, I suspect, cause more pain to the consultants than any feat of appraisal itself.

If managers see appraisal as a way of 'getting one over' - (to reflect your headline) - appraisal will, quite reasonably, be resisted.

RM Wilcox Wychall Lane surgery Kings Norton Birmingham