Why the complaints process cuts so deep

Adversarial legal terminology and the impersonal nature of bureaucracies add to the distress for doctors facing complaint

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Even doctors facing trivial complaints about their professional performance can feel their lives have plunged into crisis, a Sydney-based researcher has found.

Elizabeth Van Ekert, who is investigating doctors’ responses to the complaints process for a doctoral thesis on ethics and law in medicine at Sydney University, says many doctors feel shamed and isolated during an adversarial legal process.

“The perception is they feel like criminals,” Ms Van Ekert, who is a former investigator with the NSW Health Care Complaints Commission, said.

“A significant number of them suffer depression, anxiety, anger and guilt.”

Her observations are based on interviews with 17 doctors who had been subjected to complaints, as well as experts who support medical practitioners under investigation for a complaint.

“If we view medicine as a vocation, a complaint goes to the very core of a doctor’s identity.”

A doctor accused of a professional failing was likely to need understanding and validation, but in some cases they kept the information as a dark secret or became estranged from colleagues they confide in.

Speaking at the Australian Doctors Health Conference in Sydney last week, Ms Van Ekert said some doctors were so traumatised they walked away from medicine.

She described an obstetrician who was devastated when she was given the cold shoulder by long-term colleagues after a complaint from a patient.

“Two and a half years later she was found innocent, but she has never worked in her profession again,” Ms Van Ekert said.

Commonly, even doctors who were vindicated continued to suffer from a loss of self-esteem.

“They become very quiet and reflective.  They say, I must have done something wrong for someone to make a complaint against me.”

One doctor described the investigation process as like being on a “highway full of potholes” … He didn’t know what would happen next.  One minute they were asking him about one thing, now they wanted to look at his medical records.

Another doctor, who faced a trivial complaint from a patient and was also cleared, said the process was a blow to his sense of self.

“He said: ‘If I upset that patient, I am not a perfect person.  I must be inadequate in some way.’ “He told only his wife about the case, and she said there must be something in it or the patient would not have complained.”

Adversarial legal terminology and the impersonal nature of bureaucracies added to the distress for doctors, Ms Van Ekert said.

“Almost universally, the doctors wanted to explain their side of the story. They  aren’t callous swine.  They might want to say they’re sorry for causing someone to be upset, but they can’t.”

On the other hand, some doctors saw a silver lining in the experience.

“A few of them said, I hated it at the time, but it made me think about how I practise medicine and how I relate to my patients.”