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BMA launches major investigation into impact of patient complaints on doctors

The BMA is launching a major investigation into the psychological effect of rising patient complaints on doctors, in order to assess the repercussions on the profession.

Starting next week, the BMA will survey almost all of its members by email for the first time on their experience of complaints made to the GMC, managers or other sources.

It will also assess the impact of rising complaints on how doctors practice, asking the views of those who have not had any complaint raised against them to see if the fear of complaints is making them practice more defensively.

The study, which is led by the BMA Doctors for Doctors Unit, King’s College London and Imperial College Healthcare NHS Trust, will survey 119,000 doctors, hoping at least half will respond.

The BMA said the work did not aim to ‘silence patients’, but was designed to look at whether the impact of complaints procedures on doctors was proportionate. The union said if the study unveils any problems with the complaints-handling process the BMA will lobby for it to be changed.

The move comes after both the GMC and the Health Ombudsman reporting rising complaints involving GPs.

Recent statistics from the GMC suggested GPs are increasingly likely to face complaints, with the total number reported to the GMC in 2011 up 23% on 2010, from 7,153 to 8,781.

The BMA said that while the increased number of complaints had not let to more doctors being struck off the medical register, the professional and personal repercussions for doctors were ‘huge’ and not well understood.

BMA Doctors for Doctors Unit head Dr Michael Peters said: ‘Doctors are often terrified about complaints. If a doctor has a complaint made against them, it goes into their psyche. It is not like being an accountant who slips up; it can mean the destruction of a whole person. That is how the doctor perceives it.’

Imperial College professor Tom Bourne said: ‘This survey is the best chance doctors have had to give their views on this system — how it functions, and the impact it has had on them, their colleagues and patients.’

‘The complaints system is supposed to protect patients. Yet, if it is resulting in changes to practice, and more defensive medicine, the impact may be counterproductive and lead to a deterioration in the quality of care.’

GPC chair Dr Laurence Buckman said: ‘GPs are usually very badly affected by complaints.’

Readers' comments (11)

  • There is no doubt complaints impact adversely on doctors, morale is very low, and it does drive up defensive practice, more referrals, more antibiotic prescribing and creates more paperwork for both the practice and doctors, communication is key with patients and the only way is to enable greater consultation times, ten minutes put doctors at risk

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  • What the BMA really needs to do is launch a major investigation into why doctors are supposed to do so much to such a high standard in so short a time. With few exceptions, not having enough time is the main source of misunderstandings and error. Let's all spend twice as much time with every patient (and let someone else sort out the manpower implications).

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  • I thought that there was no mystery in how stress affects animals or people. So far 94 doctors died during GMC investigations and BMA refused to engage when it was repeatedly pointed to them who the offenders are in the medical profession. Making of false allegations against doctors by doctors such as inadequate medical directors and other doctors is a classic example.
    BMA refused to help whistleblowers who pointed to them the problem doctors.
    BMA colluded with GMC in anticompetitive policy formation and implementation such as persecution of locum doctors, ethnic minorities etc.
    It is a giggle that British Medical Journal (owed by BMA) does not expect authors submitting papers for publication to declare their conflicts of interests. It is laughable that BMJ would publish articles on ethnicity of doctors and its relation to complaints before GMC where researchers did not even take a sample to find ethnicity. Honestly, the standards are so low. Patients will complain even more as they become better educated and catch out poor doctors. Just face up to it.

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  • The problem lies in the absolute freedom patients have with no risk to themselves, and as we know, many patients are not of sound mind and have hidden agendas. These may manifest into anger against a doctor and lead to unfounded complaints. It is necessary to expose patients to the same personal accountability as any other individual who raises an unfounded complaint against a professional, that if it is found to be totally unsupportable or contrived, the complainant is at risk of being sued for defamation by the doctor's defence body. I am very surprised that defence bodies do not actually defend doctors in this way, or the GMC to reply to all patient complaints fairly on behalf of the doctor that legal action may be taken where a malicious and unfounded complaint against a doctor will be met in the same way as 'wasting police time'. After all, the tone of GMC letters to doctors often carries an element of guilty until proven innocent, but nothing to the complainant! Amazing. I would not hesitate to take out a civil action for defamation against anyone, patient or non patient, who might make totally ridiculous complaints. Clearly the government via the GMC are trying to discredit doctors so that we forget that we are the single most powerful professional body in the country, but have no functioning union to speak for us!! Even more amazing. Other countries in the world would be grateful for the level of professionalism and work ethic work we give to patient care where our government's short term goals are to privatise the health service for cash back-handers.

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  • Patients have many easy ways to make complaints about doctors, particualry GPs who are "just around the corner" whereas hospital doctors are hidden away if offices/clinics/theatres. Just a quick search on the GMC website and an electronic complaint can be made. GPs are then expected to reply within stipulated time frames to the complainant. You then have no idea (usually) whether the patient has accepted your response, or if it will come back to bite you at a later date. There is no expectation that there will be acceptance or apology for misunderstaning from the complainant - nothing. The complainant expect you to remember everything about something, however many consultations have passed since. Patients ask me why I write so much and why I put unusual comments in as quotes - I explain that I have have to try and make consultations memorable "just in case".
    I worry about doing something wrong all of the time - I want the best for my patients. But in return I hope that they will accept that I am not superhuman and can make mistakes, hopefully without dire consequenses.
    The saddest thing is those making inappropriate complaints, creating huge stress, and when thrown out by, ultmiately the GMC, there is no case to answer by the complainant. There is not even a reprimand - there is nothing to stop that person making more spurious complaints. It isn't just GPs, all clinicians, and other public sector workers especially teachers, are affected.
    I think it is time that when someone has been found completely faultless, that the complainant has to bear some cost or at least someone reprimand them. Otherwise this is only going to get worse with greater cost both in personal stress, with many people leaving the professions, and financial due to the time taken for investigation.

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  • Increasing workloads have major consequences. It causes stress and mistakes. How many patients should a GP see, how many hours should a GP work continuously in a day , as an example. We need to define health and safety levels for doctors urgently. This will stop all the extra uncosted work that is pushed on us. We will have time for patients and hey- the complaints will disappear. At the moment we pay the price of making mistakes from overwork - what an anachronism!!

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  • Doctors should have right to sue back for defamation...simple..

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  • I find it completely bizarre that patients can make complaints to the practice, to the PCT(CCG), GMC, Ombudsmen and through the civil courts if they want. What other profession has to defend themselves from this potential endless onslaught?

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  • helen.surely the bmj does have a section where contributors must declare conflict of interest? .are you thinking of something more specific?

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  • GPs must claim damages for unsuccessful complaints, BMA to seriously consider this option and draw pathways

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