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Why is it so easy for patients to complain?

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I don’t normally bother to answer the phone after 10 at night, but when the Caller ID screen pops up with “TVCntr BBC”, well, you do, don’t you?

It was generic BBC night watchman Rupert Researcher (names have been changed to protect the innocent...) calling from Radio Four’s Today programme.

The GMC was publishing its annual report on complaints against doctors the next day and as concerns about GPs had increased by over 25% since the last report, would I care to comment, especially as those relating to burned-out middle-aged male GPs being rude and disrespectful to their patients were in something of an ascendancy- nearly three quarters of all complaints in 2011 were about male doctors, though blokes make up only 57% of the medical profession.

‘We’d like to do something for the 08:10 slot,’ he said.

Those of you over the age of 35 will know that the Today programme’s 08:10 slot is the one to die for. If you’re under 35, steal a march on your less well-informed friends and colleagues and start listening to it tomorrow. It’s the time when the Chancellor of the Exchequer or the PM discusses the most important news story of the day. I’ve done the Today programme before; I’ve even survived the ordeal of a questioning by James Naughtie and John Humphreys in tandem. But I’ve never done the 08:10.

So I commented and when I’d finished commenting Rupert wondered, ‘And you’d be comfortable expressing those opinions to the listeners?’ Well, almost all of them. We might gloss over the bits about medical students being taught courses in Advanced Fluffiness in medical school instead of basic anatomy, because that got me in loads of trouble last time that got in to the public domain.

‘Er, OK. I’ll chat to my editor and get back to you. Thanks.’

While I was waiting for the call back, Dr Clare G from the RCGP tweeted ‘Hey, guess who’s doing the 08:10 for Radio Four tomorrow??’ or something similar. Not me, I reasoned, so I sent her a ‘Break a leg’ tweet and next day being my morning off, I slept through the entire programme.

So, if the Radio Four audience didn’t get the benefit of my wisdom, that’s no reason to deprive you of the Thoughts of Chairman Tony vis-a-vis the rising tide of complaints against us.

First off, it’s far too easy to complain about your doctor. In theory patients are supposed to seek local resolution, attend a face-to-face interview, be offered a full and frank admission of guilt or, more likely, a full and frank explanation of how dumb-arsed, prima facie, their complaint appears to be. Then we can file the paperwork in our appraisal folder and move on. In reality patients can and do go for the nuclear option from the start and complain direct to the GMC.

This lack of basic triage means that over half of the 7,000-odd complaints (from a total of about 300 million consultations in England alone) don’t even get past first base and of the rest another half don’t result in any sanction against an entirely innocent doctor.

Second, patients’ expectations have been ballooning out of proportion to the NHS’s ability to meet them for decades now, and the rise of the Diagnose-It-Yourself website hasn’t helped. ‘I’ve got a headache and I want a brain scan’ used to be something you could deal with rationally. ‘I’ve got a headache and the internet says I need a brain scan’ is another matter entirely. Refuse that, without spending 45 minutes explaining why and transcribing the entire conversation verbatim into the patient’s medical record, and it’s GMC letterhead time.

These answers, and the GMC’s stock reply to the publication of the complaints figures each year (‘Every complaint is a blessing’) would have been equally true in 2011, and the year before that and the year before that.

I’m sure Dr Clare G from the RCGP did a fine job addressing the issues while I slept. But there’s one point she might not have picked up, considering that she appears to be a) female and b) far from burnout.

While I’m not sure that I’m happy with my entry in the BBC’s contact file (Dr Tony Copperfield, cynical burned-out middle-aged GP bloke), it is in all respects accurate. Like every other cynical burned-out middle-aged GP I’m becoming increasingly tempted by the idea of grabbing the pension pot before the Government empties the bugger completely and leaving the joys of QOF, CQC, GPCC, CCGs and every other TLA that infests my in-tray and in-box to those who’ve known no other way of working.

One thing I surely would not advise is for the media, the GMC, the Patients’ Association and Uncle Tom Cobleigh and all to start having a go at the very  family doctors who are currently holding the system together until we have enough trained female GPs available to hold the fort, allowing for maternity, family and other issues that result in many of them working less than full time.

Ask around the next time you meet a bunch of prematurely greying GPs socially. You might, or might not, be surprised at the number who are consulting their financial advisers and spending quality time they could be devoting to filling in their appraisal website’s ‘Reflections on what I have learned today’ mugging up on the state of the annuities market instead.

It’s not good, by the way. Delay would appear to be inadvisable. I’m just sayin’.

Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder