In the last article (Medicus Newsletter, Issue 9), we considered an overview of the impact of complaints on doctors and suggested that being shamed may be at the heart of how we respond.
The emotional impact of complaints is the same the world over. Simply receiving a complaint is enough to make us feel ashamed, to want to withdraw and hide. I have spoken with many doctors who struggled to even open the letter from the Medical Council or from the Office of the Health and Disability Commissioner, and who didn’t even feel able to tell their spouse, let alone seek meaningful support from others.
On receipt of a complaint, doctors feel anxious, depressed and angry. Sometimes these emotional responses last for a very long time. Suicide, thankfully uncommon, is however well recognised and is a tragic outcome. Doctors report losing trust in patients (not just the complainant) and caring less about patients’ wellbeing. At the heart of this issue, lies the damaging effect of complaints on the doctor-patient relationship.
Interestingly, there is little correlation between the severity of what went wrong and how we respond emotionally. Understanding suffering is key. It may be because ‘being a doctor’ is such a significant part of our individual sense of personhood. Remember that suffering happens when some component of personhood is threatened – our work, our relationships, our perception of future and so on. Just like our patients…
So, what should we do to reduce these emotional impacts, to enable us to continue to do our job which is caring for patients (I challenge you to think of a better definition), and to help reduce our own suffering and look after ourselves?
My research suggests that what is needed is trained, professional, psychological help. My emphasis is deliberate. Many doctors that I interviewed reported that chatting over the complaint with colleagues was either useless - “you’re a good doctor, nothing to worry about”, or judgemental and accusatory. My advice is simple: don’t do it. Share the stress with your immediate loved ones but contact Medicus and get steered towards professional help. We have researched the outcomes of this approach, and it works.
In the next issue we will consider doctors’ ‘intellectual’ responses to a complaint, and what to do.
Dr Wayne Cunningham
General Practitioner