Complaints – The good news

In past issues, I have normally used relevant complaints cases to reflect upon and perhaps learn from. In this issue, I decided to reflect on the nature of cases that, after due process, end up at an actual Disciplinary Tribunal hearing.

There is a long, and often anxious, tail to the complaints process. What is not highlighted during this journey is that many complaints are actually addressed and closed along the way. This might be at a local level, or even at a Medical Council Professional Conduct Committee investigation level where a finding of educational letter, supervision or other such measures can be the outcome.

The very real concern is if the issue gets a Tribunal Hearing, which can involve fines, restriction of or removal of the Practicing Certificate, and of course, being publicly named.

Prior to writing this article, I reviewed all the cases which have been before a Medical Disciplinary Tribunal Hearing over the past 5 years. This totaled 41, or about 9 per year - noting there are just over 20,000 doctors on the New Zealand medical register. I can confidently say all cases represented significant wrongdoing, sometimes over a prolonged period of time, and none were one-off mistakes.

I have categorized the cases into broad themes, and the following list is what I found:

• 13 of sexual misconduct

• 7 of fraud or dishonesty

• 6 of serious court convictions

• 5 of prescribing to self and/or others close to you over multiple years (generally involving analgesic benzodiazepines and mental health medications)

• 5 of medical failure to follow accepted standards of care (often over a period of time, such as repeatedly missing a diagnosis)

• 2 of accessing notes inappropriately

• 1 of conducting clinical trials inappropriately

• 2 regarding COVID-19 misinformation

When one receives a complaint, there can be an overwhelming sense that the worst may happen, which can generate a great deal of fear. Fear can be very destructive and is often disproportionate to the actual reality of the issue at hand. One way of managing fear is to analyse the risk in terms of what is most likely to happen. What this analysis tells us is that the likelihood of actually ending up before a Tribunal is extremely low and is generally predicated on very poor behaviour or a significant departure from medical care or processes.

As doctors we should be encouraged by this and feel confident that if you practice safely and mean well even when we do make errors (which we all will do at some point in our career) the system will not overly punish those errors.

That in my opinion is good news and a reason to not fret unduly when a complaint is received.

Dr. Andrew Dunn

General Practitioner