It is a similar situation for patients who draw attention to problems - i.e. people who make a justifiable complaint about the way they are treated or have been treated. They often experience, or fear that they will experience, victimisation or reprisals.
When I was speaking to the orthopaedic surgeon earlier this year at my final meeting with him after an operation on my arm that had resulted in a worsening of the problems it had been expected to remediate, I asked him if it would do any good for me to write a letter of complaint to the manager of the hospital. It was a little difficult to get him to commit himself to an answer, but he did eventually say that in his opinion it would do no good whatsoever and would result in no change.