System for handling complaints against doctors 'compromises patient care'

The current system for dealing with complaints against doctors damages their wellbeing and causes fear-driven working practices that could compromise patient care, researchers have warned.

The researchers, from Imperial College London, found that ‘poor processes, prolonged timescale and vexatious use of complaints systems’ are reducing the psychological welfare of doctors.

They added that these issues are driving doctors to practice defensive medicine including over-prescribing and sending patients for unnecessary scans and procedures.

Published in BMJ Open, the study asked over 6,000 UK doctors with past or current complaints against them to complete an anonymous online survey.

The majority (78%) of doctors said complaints procedures went on for too long and two fifths (39%) felt bullied by the complaints process.

Doctors said they worried most about professional humiliation (80%) following a complaint. This was followed by having a marked record (78%) and public humiliation (70%).

Around 9,000 doctors a year are reported to the GMC, resulting in around 160 being suspended or erased from the medical register.

Complaints process

Problems arise because many complaints are also investigated formally or informally by practices – meaning a doctor could be investigated a number of times for the same issue over a drawn out period, the researchers warned.

They added that perceived support from colleagues and management was associated with a reduction in these effects.

Two thirds (61%) of doctors said they felt supported by colleagues, and these doctors were 36% less likely to experience depression and 31% less likely to experience anxiety.

Lead author Professor Tom Bourne said: ‘Patient complaints are important and should be used to improve the care doctors provide. However, the processes used to investigate them should be consistent with the principles of natural justice.

‘The current culture of fear causes physicians to practice defensively, which is clearly not in the interest of patients and creates significant costs for the NHS. We must develop a system that’s fair and timely.

‘Authorities can help reduce the impact of these procedures on doctors’ wellbeing by imposing time limits on investigations, and making them more transparent and less adversarial. This will benefit patients by reducing defensive medical practice.’

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