Practice dilemma: When staff and patients gossip about the GPs

You overhear a member of your team criticising another during surgery. What should you do?

The dilemma
Towards the end of the day, the last patient had left the door open and as I was finishing some paperwork I did not bother to close it. The practice was rather empty and I overheard the receptionist and somebody else talking about a doctor in the practice. They feel she is arrogant, unhelpful and rude.

Although I could not see their faces I recognised the receptionist’s voice, but I do not know to whom she was talking. It could have been one of the patients. What should I do?

A GP’s view
Dr Peter Ilves, GP in Roehampton, London

Before you follow a course of action you should gather as much information as possible.

There is a world of difference between this receptionist talking to a fellow member of staff or to a patient. The former is at best idle chatter and at worst is misrepresentation, defamation of character and may undermine the functioning of the team. The latter is at best serious misjudgment and at worst a significant breach of professional conduct.
The partner mentioned would probably want a hard-line approach to be taken.

Dealing with the partner is a separate issue, but not one to avoid. The receptionist’s comment may be true and this should be an opportunity to bring this to the partner’s attention. If the GMC code of conduct is being breached this must be dealt with.

If you are certain of your facts the receptionist should be talked to as soon as possible. There are three routes that could be taken, depending on the receptionist’s previous conduct and employment record.

The first would be to take the member of staff to a confidential space and ask them to explain their behaviour. It might be that this provokes an apology; this combined with a reassurance that this would never happen again could be enough to end the matter.

If the receptionist had been talking to a patient a disciplinary measure might be necessary. The regulations should be followed carefully and appropriate records made throughout. The second party involved may be needed to give a statement of events. The outcome of this would be a formal record in the receptionist’s employment folder.

The third option is dismissal. This significantly indiscrete conversation could be argued to have wide-ranging implications. It is unprofessional, it undermines the integrity of the partner and the practice, it could be seen as a form of breach in confidentiality and it leaves employers uncertain that other breaches may be occurring.

A medico-legal opinion
Dr Des Watson, medico-legal adviser at the Medical Protection Society

You would be unwise to ignore this overheard remark, but you need to consider the position carefully. Note down the time, date and circumstances, the words you heard and who you think the speaker was.

Either you, a colleague or perhaps the practice manager will need to speak to the member of staff involved and confirm the position. Thereafter the position will depend on whether the matter was raised by a member of staff or a patient.

If a patient has raised the issue then the practice should consider using the complaints’ procedure to investigate and resolve the issue.
The receptionist should have recorded the initial complaint and offered access to a formal practice complaints’ procedure. If the identity of the patient can be confirmed, a telephone call from the complaints’ officer to the patient to offer a formal process may save difficulties in future.

If it was a member of staff then action still needs to be considered. If the doctor in question is perceived as arrogant, rude and unhelpful, it is possible that patients have the same experience.

You may be the doctor in question so reflect on your own interactions with staff and patients when deciding who should approach the receptionist.

Remarks like these, if made by a member of staff to a patient, increase the risk of patient dissatisfaction and litigation. There may be an issue of staff training to consider.

A patient’s view
Ian Semmons, Patient Partnership Group

This situation needs to be treated with extreme caution because, if mishandled, the potential for serious damage is high.

You have heard comments that are critical of one of your colleagues yet you do not fully know the context in which they have been made.

Your receptionist is likely to be aware that you are on the premises and it might be that she is frightened to come to you directly to discuss this matter.

Her ‘loose’ conversation could be her way of alerting you to a potential problem.

Within the practice you should have a grievance procedure that clearly states the correct route for voicing any concerns.

It would make sense to ask the receptionist to come into your office in order to discuss what you heard.

You also need to establish to  whom she was speaking while stressing that such conversation is not acceptable. The correct procedure for raising concerns should be reiterated to ensure that your receptionist fully understands this.

It is important to establish some facts: on what grounds does your receptionist make her claims? Can she give any examples that can be substantiated? Have there been any complaints from patients?

With a clearer picture you can then decide on a course of action. If there is evidence to support her claims then you need to discuss the issue with any other partners within the practice. The situation needs to be resolved promptly to ensure that patient care is not compromised in any way.

If disciplinary action is needed, it is essential that you follow the correct procedures and that everything is accurately documented.

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