I got my fingers burnt badly by my continued contact with the MDS. After I had been refused renewal by the MDU after 17 years, which then triggered a series of domino effect refusals from the MPS and MDDUS, all based on the so-called Letter of Good Standing that purports to only display the headline allegations of complaints that were raised with them but never go beyond that into the respective merits or outcomes in each case, I was then tossed around the private indemnity market very exploitatively by being labelled as a 'distressed doctor' who quoted me outrageous premiums as high as 47k or not at all.
At this stage the MDS stepped in promising to offer me a lifeline by looking at the cases with compassionate clinical eyes and ensuring I was given fair treatment. It bears mentioning that all bar none of the dozen or so cases over a decade were vexatious complaints that were settled at practice level, but which continued to dog me by remaining on my record, and continued to be treated as a disgraceful stain by all the underwriters sittting in judgement over me. The MDS asked for and I provided chapter and verse on each of the complaints. To my disappointment, after being accepted but strung along for 5 months of being assured they would be launching imminently, I was offered membership but under extremely humiliating and completely unworkable conditions.
The first was that I would have to attend a communications skills course conducted by the RCGP every year, and provide documentary evidence of this. Fair dos. Whether or not the complaints were due to my skills not bring upto scratch, I thought to myself it's never a bad idea to attend such courses. However, the second condition was well and truly bizarre. I am a peripatetic locum, and now I was being told I could only work in a total of three practices over the next two years. When you consider that the first three practices I worked for since April (when I renewed my indemnity with a private organisation at great expense but with no such restrictions) have only called me back for 2 more sessions, none and 3 sessions respectively, with no promise of ongoing work, you have a dead duck in the water. Not only would I then be stuck with no recourse to locuming anywhere else despite a full set of skills and availability, but I would quite literally starve, let alone be able to afford either the indemnity or keep my skills upto date. The chairman, who had been dealing with my application from the start, and himself a GP, suggested why don't I work as a long-term locum or even salaried, as that would surely solve my problem? My answer to that was quite straightforward. If you could guarantee me that the first three practices that employ my services will all have me for regular sessions over two years--something which even they cannot foretell--then I could just about imagine doing so. I do not wish to be salaried at present for personal reasons, with unwell family abroad that is simply not an option.
It is akin to saying, why don't you try to secure a job that pays you a quarter millions pounds a year? I had been led to believe that with jobbing GPs on the board deciding on my application, there might be some semblance of fairness to the process. But no, they too decided that I was too high a risk to be let loose on an unsuspecting public and had to be reined in lest I wreak further havoc. All this, mind, on the strength of a series of completely unfounded, trivial and proved baseless complaints that I was judged to be found wanting over, merely for the fact that someone had decided to complain, regardless of the facts of the matter. This is exactly what all the other indemnifiers have done so far after the MDU kicked me out, and what the MDS have also now put the boot in in the same way for. It feels like being convicted solely on the fact that one has been arrested, whether or not that is followed by a charge, a defence, a trial or even an acquittal.
As I said, what shocks me the most is how colleagues who constitute the MDS board have decided the matter with their clinical brains on, and conveniently blamed it on the risk-averse American lawyers underwriting their organisation.
After 5 months of patiently waiting while I was potentially offered an affordable indemnity but at a price that even Satan could not afford, I have been left feeling very bitter about being strung along by this start-up which promised the earth to begin with. I doubt they have the faintest clue about how locum GPs work in the UK. I do not intend to touch them with a bargepole again.
Anonymous 12.35, absolutely brilliant and accurate analysis of many of my own thoughts while reading the article. I too am experiencing the increasing divorce from hard reality that the MDOs continue to espouse with their pious platitudes.
Totally agree with Shaba about the defence bodies' kowtowing attitude and the 'do anything possible to avoid a complaint or escalation of one'. Sometimes you don't have to say sorry because you're not wrong, and sometimes you don't have to get bogged down in arguments over why you're not prescribing. I encourage all my patients to get OTC medications OTC, and have never failed to attract venom, criticism and outright aggression. Does that influence my prescribing? No, otherwise I'd just be turning into a cardie! Of course the point about getting everybody on board for consistency is very important, orherwise they'll try gaming the system and play us off against each other when they detect weaknesses there. I must sat that I am increasingly ashamed of the MDOs' stance of encouraging meek and self-flagellating responses when the case is clear-cut.