GPs twice as likely as other doctors to quit over medico-legal fears

GPs are more than twice as likely as doctors in other specialties to leave their job because of fears around making errors or being exposed to medico-legal risk, a GMC survey reveals.

Medico-legal risk (Photo: GMC)
Medico-legal risk (Photo: GMC)

The medical regulator’s poll of doctors leaving the profession found that GPs were much more likely to experience worry about errors or medico-legal risks (24%) compared with specialists (10%).

The findings came as polling by the BMA suggested more than half of GPs could be prepared to quit the NHS if the government failed to provide the profession with the support it needs to get through the pandemic.

The GMC found that GPs were almost twice as likely to report burnout as a reason for leaving (43%) compared with specialists (22%). However, their levels of dissatisfaction were similar to other doctors at 37% for GPs, compared with 36% across other groups.

GMC investigations

Family doctors were also less likely to return to work once they had left their roles than other doctors, the GMC found. Only 9% of GPs were likely to go back compared with 25% of hospital specialists, and 32% of trainees.

But the GMC said that this was ‘likely’ related to the fact that a greater proportion of GPs left their roles due to retirement.

A survey by the Medical Protection Society (MPS) in February found that more than three quarters of GPs fear the COVID-19 pandemic would leave them facing investigations triggered by factors outside their control, such as delayed referrals or disruption to services.

The MPS has previously predicted ‘a significant number’ of medico-legal disputes and warned that the impact of investigations on ‘already emotionally and physically exhausted' doctors will be ‘significant’.

Patient relationships

MPS medical director Dr Rob Hendry suggested why GPs might be more likely to quit over fears of medico-legal risk. He said: ‘While all doctors worry about making mistakes and causing harm to their patients, it is understandable that some GPs feel this more acutely.

‘There is the sense that the buck stops with the GP; they have the first contact with the patient and the responsibility to assess, diagnose and recommend appropriate treatment or referral. They also often have a closer relationship with patients, their families, and prominence in their local community, which increases the pressure.’

Dr Hendry added that the ‘significant resource constraints’ in general practice, ‘high patient expectations’, and increasingly complex health needs were adding to pressure on GPs.

Formal investigations could also be a harrowing process, he explained: ‘A GMC investigation can often take several months - and sometimes years - to conclude.  A hearing itself can last several days if not weeks, and the press can attend and report on the case which can create long-term reputational damage and a sense of shame for the GP. The whole experience is hugely stressful irrespective of the outcome and GPs are naturally fearful of facing this.'

Dr Hendry said there was ‘still more to be done’ by the GMC to improve its investigation process. A previous MPS survey found almost a third (28%) of doctors who had faced investigations considered leaving the medical profession as a result of their experience, while 2% actually did.

GMC acting chair Professor Dame Carrie MacEwen recently said that the COVID-19 pandemic had struck a 'hammer blow' to the already-fragile wellbeing of the medical profession. It has also led to high levels of burnout among GP trainers.

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