Doctors under complaint suffer stress and anxiety, study shows

Doctors under complaint suffer stress and anxiety, study shows

According to the study* published this week in BMJ Open 16.9% of doctors with a current or recent complaint report moderate to severe depression, compared to doctors with no complaints (9.5%).

In addition, 15% reported moderate to severe anxiety compared to just 7.3% of doctors with no complaints. Distress increased with the complaint’s severity, the study found, with highest levels after General Medical Council (GMC) referral (26.3% depression, 22.3% anxiety). Doctors with current or recent complaints were also 2.08 times more likely to report thoughts of self-harm or suicidal ideation. 

Doctors with complaints also reported practising more defensively. And complaints clearly affected their relationship with their colleagues. Some 20% said they felt victimised after whistleblowing, 38% felt bullied and 27% spent over one month off work. 

Professor Tom Bourne, lead author of the study from the Department of Surgery and Cancer at Imperial College London, said while it was essential to investigate the reasons things have gone wrong, the regulatory system for complaints has “unintended consequences that are not just seriously damaging for doctors, but are also likely to lead to bad outcomes for patients. We think this needs to be looked at carefully by policy makers.”

The study looked at the impacts of the complaints procedures on the welfare, health and clinical practice of 7,926 doctors in the UK. 

Commenting on the findings, Dr Maureen Baker, Chair of the RCGP, said: “Patient safety must be paramount in any complaints or fitness to practise process, so any system that has negative consequences for our patients needs to be reviewed. It is also important that a sense of ‘innocent until proven guilty’ prevails throughout any investigation, and that steps are taken to ensure that any associated stress is kept to a minimum.

“In terms of the GMC fitness to practise process, whilst we understand that they must thoroughly investigate allegations of malpractice, lengthy investigations are not in anyone’s best interests and so we would urge the Council to speed up the fitness to practise procedures where possible. GPs across the UK are reporting high levels of stress as we struggle to provide care to our patients, often in very difficult circumstances due to lack of funding, significant increases in patient consultations and difficulties in trying to recruit sufficient GPs to meet patients’ needs.

“This report strengthens the RCGP’s calls for more support for GPs, so that we can do whatever we can to prevent problems arising in the interests of patient safety, in the first place.”

Niall Dickson, Chief Executive of the General Medical Council, described the findings as ‘a valuable contribution to an important and difficult issue which we take seriously and are actively addressing.’

“The number of complaints about doctors and other health professionals continues to rise and anyone who is subject to an investigation is bound to find it stressful, especially if the national regulator is involved. But, of course, our purpose is to protect patients and when serious allegations are made, we do need to investigate to establish if there is a case to answer.

“At the same time, we have a duty of care to these doctors. That is why we are doing more than ever to reduce the stress of our investigations, by offering support and doing everything we can to reduce the time doctors are in our processes.”

He explained: “Since 2012 we have introduced a new support service run by the BMA for any doctor in our procedures, we are referring less serious complaints to be dealt with locally, we have introduced meetings with doctors to resolve cases more quickly and established the autonomous Medical Practitioners Tribunal Service which is also taking steps to speed up the process. 

“We recently published an independent review of doctors who had, or might have, committed suicide while under investigation and following that we have committed to a major review of how we support vulnerable doctors under investigation.”

* Tom Bourne, et al. The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey. BMJ Open 2015;5:e006687 doi:10.1136/bmjopen-2014-006687

By Jo Carlowe,

OnMedica, Friday 16th January 2015

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