It is a fact of being a doctor these days – some of your patients will sometimes complain about you. Whereas the ‘complaint’ used to be the clinical problem that the patient brought to the surgery- it is now also something that some patients may brew up during a consultation, or else-insulted- leave your care with. The potential of complaint is a constant threat to the personal and working life of a doctor, no matter how justified its communication or substance, and no matter the competency, empathy or humility of the doctor concerned.
Whereas before, when a culture of blame and distrust was less prevalent in society, and when a doctor was usually held up as someone who it was understood could or would ‘above all do no harm’, complaining about care was hardly ever heard of, it is now very much part of the roadmap of giving and receiving medical care, especially if the patient is litigiously minded or unable or unwilling to gain satisfaction in any other way.
The MPS and MDU are increasingly busy conflict resolution organisations – their relationship with doctors is intimate and evermore important. The GMC is also nowadays very busy dealing with a burgeoning number of disciplinary complaints that previously might otherwise have been dealt with more locally, in days where, arguably, transparency was less valued, and where local teams of medical staff regulated themselves, in firms etc.
From any doctor’s perspective, receiving a complaint is very stressful. It often comes as a shock. If not a lengthy suspension, it may signal the start of a long period of enquiry, extra work and self-questioning heartache. It may even lead to criminal action or being struck off from an extremely hard won career. Often there is a series of psychological hurdles to get over if the doctor is to feel the same about herself and her work ever again. The time it takes to process complaints is one area which compounds the stress and this is currently being looked at by the GMC. Look at the GMC website for more information and to take a survey by 10/5/2015 about this.
Recently I heard a talk by a barrister who defends doctors which presented a very interesting picture of a medical profession who relies on the GMC in a time of highly defensive medical practice. The question she asked is a good one: it is about the nature of the ‘public interest’ in which this culture of exacting enquiry exists. Is the public really being best served by a complaints culture which defends itself to a highly shaming and blaming tabloid press, she asked. Perhaps it might be better if it moved towards defending itself to the public at large who really urgently need doctors to do their best, in difficult times and places?
No doctor wants to see poor practice and for there to be a regression to the times where patients felt they could only be grateful for care or where power dynamics were so unfairly stacked in favour of a self serving medical profession who could do no wrong, no matter what they did. But surely patients do not want doctors to be so stressed out that they cannot practice at all, or only practice highly defensively- for fear of not being able to try to do their very best.
doctorgoodstress 