‘I don’t want to talk to you. I just want to confirm your full name and tell you that you will have to defend your actions in front of your peers.’ Her tone was angry and intensely spiteful. The conversation was over before I could speak and it left me shaken. We had never met. She was the relative of a patient who two days earlier had been in my consulting room with symptoms of confusion, malaise and cough, and 30 minutes after leaving had collapsed with a massive stroke, but survived. It was evident the relative was not interested in any explanation or facts. She just wanted my head on a plate.
I hoped that the threat of action would not be followed up, and was just a way of the relative coping with shock and grief. I was confident that I had done the right thing, and my partners and doctor friends agreed.
But four weeks later I opened a letter from the GMC informing me that I was now the subject of a fitness to practise investigation. It left me stunned and deeply fearful for the future of my career. Last year, nearly nine thousand of us were the subject of a formal complaint to the GMC,a rise of almost a quarter on the year before. Next year, it might be you, and no matter how sure you are of your actions, the effect on your self-confidence and on your attitude to your patients may shock you.
I consider myself a conscientious, hard-working GP who genuinely cares about patients, so to be accused of being uncaring and incompetent and perhaps not even fit to practise felt like a slap in the face. It may sound illogical and self-pitying, but I felt that I had been betrayed by my patients as a whole.
And the fact that two lines sent in anger by email to the GMC could result in a full-scale, four-month investigation of my competence made me feel intensely vulnerable. It just seemed too easy for a patient to complain and cause me such stress. As old-fashioned as it sounds, I felt strongly that the complainant should have been made to write a formal letter. I understand the GMC wishes to be more accessible to the general population, but a brief email seemed to make complaining too easy, leaving doctors open and vulnerable.
Confidence that the GMC would see things my way evaporated during sleepless nights. Thoughts of ‘what if I have to go to court’, ‘what if I get struck off’, and ‘I don’t know anything but to be a doctor, what else could I do?’ ran through my head repeatedly, usually at 3am when things always seem worst.
I had great support from family, friends and partners. My defence union proved invaluable, and the GMC concluded my case with no further action being taken.
I feel no joy or vindication; I’m just grateful I was spared the humiliation of a public hearing. If, however distant in the future, another patient or relative decides in anger that I should be held to account, this earlier investigation could count against me as I will no longer be able to use the lack of any previous investigation as a mitigating factor, even though this one found in my favour. It is a black mark against my name that can never be erased and I find this immensely unfair.
I am aware that patients are more demanding, and more likely to complain, so I feel like I am now at their mercy. My medical practice is more defensive as a result and if we all start to act this way, health costs will rise. My notes are the length of short novels because I now wish to document immensely detailed follow-up plans and all my thoughts relating to a consultation. My interactions with patients are now tainted by a faint mistrust, which saddens me.
At the same time as we are under immense pressure to ensure patient satisfaction, we are also expected to reduce or maintain the cost of the care we provide. But the Government cannot have it both ways. In a climate where patients are more likely to complain and it is harder for us to provide the care they expect, more and more of us will go through what I just experienced. I ask myself whether it’s worth it.