>>13403800It's not a robust system
In the case of electronic notes, there will be a record of edits and all previous versions of a record will be saved, if not immediately accessible.
With paper records, it relies on the primary senior doctor on the team knowing the case and the events, thereby allowing them to recognise if someone has tampered with things or made an omission.
There is not really much safety net to prevent the senior from altering the record. However, if an individual is found to have done that, it's generally speaking the end of their career and they can lose their license. In addition, it is very unusual for a doctor to only begin behaving unethically when they get into the top flight. There will be instances of unacceptable shit before then and they would already find themselves out on their ass.
Conceivably, someone could weasel their way through training, get a top job, then start fucking around and hope nobody notices.
