The true cost of a trivial complaint: RACGP Vice President speaks out

Jolyon Attwooll

10/02/2023 3:44:06 PM

Dr Bruce Willett sums up the stress, legal back and forth, and lost time involved in a patient complaint that came to nothing after 10 months.

RACGP Vice President Dr Bruce Willett
RACGP Vice President Dr Bruce Willett believes AHPRA could handle vexatious complaints more efficiently.

The lead-up to the complaint that took up a hefty chunk of Dr Bruce Willett’s life last year is only too clear in his mind.
It was December 2021, and Queensland border restrictions were about to ease as the state shifted its pandemic settings and re-opened to the outside world.
Like many general practices, Dr Willett’s Brisbane clinic was adapting to the changes, and had brought a mask requirement into place as a state-wide mandate for their use was reimposed.
One patient was decidedly unhappy about the situation and, not for the first time in the pandemic, general practice staff found themselves in the firing line.
‘She became quite abusive at the front desk about not wanting to wear a mask, saying that the staff couldn’t make her wear one,’ Dr Willett told newsGP.
‘She was asked to sit outside, and in the end she did.
‘And I … told her that her behaviour was inappropriate, that she can’t yell at the staff, she can’t treat them like that, that it’s not on.
‘As a consequence of that she put in a complaint, mostly that I yelled at her, which was not true.
‘That was the nature of the claim.’
Dr Willett, who is the RACGP’s Vice President as well as the Queensland Chair, discovered these details when he received a letter from AHPRA the following month.
It would not be for almost another 10 months – towards the end of October 2022 – that the complaint was finally dismissed without further action.
In the meantime, Dr Willett describes its significant impact – not least with the administration required adding up to almost a standard working week.
‘Eventually it’s all dismissed, that’s fine and good,’ he said.
‘But in the meantime, it probably took about 35 hours of writing reports and reviewing them and going backwards and forwards to medical defence.
‘Even though on the face of it, it would appear from the initial advice from medical defence that this is unlikely to go anywhere, they say you need to take it seriously because if you’re not careful it will, which I think is very good advice.
‘You would like to be able to write back and say, “This is just ridiculous!”’
Despite being a highly experienced GP, Dr Willett says the process took its toll.
‘It is stressful,’ he said. ‘Even in a case like this, where you’re pretty convinced that you haven’t done anything wrong, it is stressful.
‘And it does undermine people’s confidence.
‘If I was a junior doctor just starting out, it would be devastating. And I wouldn’t be surprised if it’s one of those things that actually leads people, if it happens early in their career, to leave general practice.’
On that note, Dr Willett has concerns about the way the correspondence, such as the letter he received, is framed.
‘It is a presumption of guilt, that you should reflect on your actions, which to be honest everyone will do,’ he said.
‘But the way it’s written it definitely gives a kind of feeling that you must have done something wrong.’
According to Dr Willett, there is no way of telling if the complaint made against him has been classified as a vexatious one – although he suspects not. He simply received a letter saying no further action would be taken.
AHPRA does not publish any indication of the amount of trivial or vexatious complaints that it receives. Its latest annual report showed that of 5874 closed notifications, 58.2% led to no further action, while on its website, it cites research indicating that less than 1% of notifications are vexatious.
‘There is greater risk of people not reporting concerns than of people making truly vexatious complaints,’ it states.
In response to a newsGP inquiry, AHPRA said that while it does not publish categories of trivial notifications, ‘our data shows that 70% of notifications can be resolved during our assessment of the concern, usually with input from a practitioner, without the need for formal investigations.’
It also states that regulators need to have ‘good processes’ for dealing with unfounded complaints ‘quickly and fairly’.
However, Dr Willett strongly queries whether that is happening and believes complaints similar to the type made against him have skyrocketed since the onset of the pandemic.
‘My sense talking to the medical defence organisation is that they received a whole slew of complaints, either directly or indirectly related to vaccinations and the mask mandate, which really elevated things,’ he said. 
The latest annual report from the National Health Practitioner Ombudsman (NHPO) tells a similar story, with a large increase in complaints relating to AHPRA and the Medical Boards mostly driven by people raising concerns about regulatory responses to the pandemic.
An AHPRA spokesperson confirmed that timeframes for managing complaints during 2021–22 was ‘longer than in previous years’, with more than 10,800 complaints received.
‘Like many organisations, AHPRA dealt with COVID-related resource challenges throughout the year, and this sometimes had an impact on our performance,’ they said.
They also pointed towards AHPRA’s latest annual report, which shows around 40% of all notifications were closed within three months and more than 70% in less than six months.  
‘We recognise that it is very stressful for a health practitioner when a notification is being considered,’ the spokesperson said.
‘We continue to undertake extensive work to improve timeframes and help both practitioners and notifiers better understand and navigate the notifications process.’
However, Dr Willett believes more changes are needed so GPs avoid an unnecessarily lengthy and stressful process.
In particular, he wants a more effective system introduced to allow complaints such as his to be categorised and dealt with more efficiently – ideally within one or two months.
‘It’s probably a combination of resourcing and also the way the complaints are approached,’ he said.
‘A triaging process would be really helpful.’
AHPRA responds that in 2022, the Medical Board of Australia created a triage committee specifically ‘to speed up the resolution of lower risk concerns’ and says the average time to manage complaints is reducing as a result.
Dr Willett also believes that legislation allowing medical boards to ‘name and shame’ GPs before an investigation is complete in certain circumstances should be mirrored with a similar mechanism working the other way in the case of trivial complaints.
‘It would seem to me reasonable that the reverse of that should be possible, where there is clearly not sufficient evidence, that things could be dismissed relatively quickly instead of having to go on for long periods of time like this,’ he said.
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Dr Miller   11/02/2023 4:28:30 AM

AHPRA fails to activate their vexatious complaints framework.
I had 11 complaints from the same patient over 5 years, and each time AHPRA and HCC "investigates" exactly the same notes and each time few months and no actions results after a LOT of time and legal letters. They know the patient is under IVO, hundreds of complaints against other doctors, the patient even tried to shoot her psychiatrist. Still - each time painful investigation with exact same outcome, for exact same notes.
There should of been a system to protect doctors - I need informed consent to accept patient who is danger and attacked previous doctors and keep complaining to AHPRA to all of them - but there is no way for doctors to protect ourselves in the current system.
AHPRA complaints due to lack of standards are now blackmailing tool for drug seekers and compensaiton lawyers - "it's easier for you to pay than to come through multiple AHPRA investigations"

Dr Robert William Micallef   11/02/2023 7:07:22 AM

The legislation around this should be changed. Perhaps the patient needs to go through a check list before ahpra accepts the complaint to weed out the non clinically relevant complaints. The doctor yelled at me type of complaints could then be rejected unless there was some kind of non subjective clinical malpractice. The other thing that could be changed is allowing consequences for trivial or vexatious complaints such as awarding costs against the complaint to recover legal fees.

Angie   11/02/2023 7:24:32 AM

Oh yes. Have gotten complaints about:
Not being able to get an appointment… how is that even a medical issue?
Not prescribing S8’s to someone who was physically abusive and who we later not only had to call the police for, but spent a good hour hunkering down in locked and barricaded rooms because he refused to leave

Luckily it didn’t take 10 months. Dismissed after a few months. Still a ridiculous process. If they had simply just called the complainant, it would have been very obvious who was the abusive one

Dr Michelle   11/02/2023 7:32:00 AM

I think we need to call for an investigation/royal commission into AHPRA processes and governance. the community and the profession need more transparency.

Dr Mark Frederick Fletcher   11/02/2023 9:49:03 AM

Regulatory bodies love to meddle with rubbish. Hammers, nails and all that. Just disband them all.

Dr Stewart James Jackson   11/02/2023 10:31:39 AM

Complaint made. No further action taken . Not really dismissed or found vexatious. I refuse to be distressed by this . Instead I describe my emotional response as cold resignation. Let patients complain. May 1000 complaints a minute rain down on AHPRA ‘s desk. AHPRA has been weaponised against us. We are a meek bunch though. Our own college should go to war against AHPRA but instead follows it’s dictates specifically with CPD.

Dr   11/02/2023 10:51:58 AM

Dr Willett is a Vice President of RACGP and QLD Chair and claimed to be an experienced GP .....
what have you done as a Vice President of RACGP while you are in this position to support doctors who had vexatious complaints? what was the strategy of RACGP towards this issues ? what did the RACGP do to support the members?
You started to speak up when it comes to you personally but as a person in charge , what did you do before that? or when it hurts you started to speak up!
You mentioned, you want an effective system to deal with these complaints with in 1-2 months !!! sorry mate , I dont agree with you, this kind of complaints should be dealt within 5-7 days maximum , if AHPRA cant do it , dismiss .... we need strong leaders to do the work, if you cant do it mate , get off your white horse and stay in your clinic .

Dr Richard Mark Smith   11/02/2023 11:05:38 AM

A caring regional country GP from my MBBS UniMelb cohort of 1977 ceased clinical practice 20+ years ago due to the trauma caused by a vexatious and unsubstantiated patient complaint.
I am aware of another situation where a mother complained to AHPRA when her daughter cried and objected during an immunisation. This resulted in an investigation, which was thrown out.
No apologies.
No explanation
No care.
What a tragedy!

Create a list of exemptions
Apply this to all complaints
Have independent peers review the complaint
Develop a model for allocation of costs to all parties.
Recognise doctors' emotional needs by researching the effects of complaints

Dr Bella Weisman   11/02/2023 11:10:15 AM

I believe that charging system should be introduced to people who enjoy writing the complaints creating a lot of stress for doctors. As other doctors mentioned most of those complaints are false and created by those people sick imaginations and false beliefs. People have to understand that writing those complaints may lead to consequences. The more silly the complaint the higher price money wise they should pay before investigating this complain.

Dr Kev   11/02/2023 11:33:27 AM

I feel for you Dr Willett and sorry for your experience.
Been there! ridiculous claims and ahpra immediately treats you as ‘guilty until proven otherwise’.

A simple human to human (ahpra to GP) phone call !without judgement! would resolve most of these complaints on the spot I believe.

However, the current policy would rather send you a threatening letter/email, and then exactly what you said ensues.

You are right though, a obnoxious complaint against a junior doctor that ahpra latches on to would likely have huge effect on their future GP profession.

Dr Roberto Celada   11/02/2023 12:40:53 PM

I suppose, I have been just lucky. I have never had to deal with a complaint to AHPRA in my 40 years of practice. I never tolerated abusive patients and apart from asking my own abusive patients to find another clinic, as a practice owner, I did also ask abusive patients of junior doctors to never return to the practice. It was all professional with a polite letter and explanation to the patient of our ZERO tolerance for abusive patients. Some of them tried to return to the practice after a few years but they were flagged and never allowed back .

Dr Patrick Fergal McSharry   11/02/2023 2:08:57 PM

So far behind Global Norms at present IMO .
Crystal Ball is at hand though so ... :)
So my prediction , just like in North America, whole thing will "balloon" out of control and Registration Fees will become so high (to sustain the enormous staff needed to investigate every complaint and notify the "Defendant " after a few months ) , then the only option is to move to "Light Touch " Regulation. Probably 5 or more years away ....

Dr Paul Po-Wah Hui   11/02/2023 6:37:24 PM

Complaints against doctors and staffs are mostly about attitudes and behaviours. The complainants want fairness and an unpleasant experience recognised and rectified. Sometimes, a simple explanation and sincere apology is sufficient for a misunderstanding. I don’t like to trivialise the feelings of those who complain but at the same time, the hurt to the one who has received unfair accusations should also be recognised. A phone call from a sympathetic official of HCCC instead of an official letters with seemingly threatening words can certainly improve the process by giving the commission a human face. My recent experience with the HCCC has been good and it was resolved satisfactorily within 4 months time.

Dr Craig Stuart Hilton Herron   11/02/2023 8:54:52 PM

So when the complaint is found to be unfounded, where does APHRA direct the patient's apology. I find that they always seem to get lost in the post somehow ....

Prof Max Kamien, AM. CitWA   11/02/2023 8:59:12 PM

Several years ago I was a panel member of a SAT in a case brought by the Medical Board of Australia against a doctor. Limitations were placed on his scope of practice. He then made a complaint to AHPRA about advice I had given a patient 20 years before. It was dismissed. I spoke to the lawyer who had processed my case and it had not occurred to him that the complaint could be vexatious.
AHPRA’s ethical defect is that its legislation places the proverb that ‘there is no smoke without fire’ above the legal principle of ‘innocent until proven guilty’.

Dr Muhammad Iqram Pervez   11/02/2023 10:34:59 PM

had a false complaint, took over 12 months to resolve. ended in no action but it took its ultimate toll!!!!!

Dr Iain   11/02/2023 11:07:49 PM

And this is one of the reasons I have quit general practice after almost 20 years, along with Medicare and the atrocious way GPs were treated during the pandemic where we learned of public health policy changes from the news and were not considered front line health professionals. Wouldn’t recommend GP to any medical student or junior doctor.

Dr Dion Micheal McNeice   12/02/2023 7:44:41 AM

Don't forget the implications on your medical indemnity premiums. My vexatious complaint which eventually was thrown out made my premiums go up about 1k/year compared to my fellow colleagues at the same stage, so it's an ongoing reminder.

Dr Caroline Chin   12/02/2023 2:35:24 PM

I also had a complaint that was dismissed (after innumerable hours going over notes and investigations that had little to do with me). No apology from client either. It appears the legal company did not know who to "blame" and to cast a wide fishing net they advised the patient to refer to HaDSCO to make an online report which then went directly to AHPRA. All doctors involved in the patient's care was notified to defend themselves. It's that easy.

Dr RS   12/02/2023 10:35:18 PM

For all the Chagrin and outrage that we feel about trivial AHPRA complaints, we need to recognise what the general public’s attitude towards us is. The perception is still that doctors are being protected and need to be punished more severely for any wrongdoing whether serious or not, including charging fees, being late, not giving patients a timely appointment etc. So these patients ( not all) pressure the politicians and the Ahpra response reflects this. Add to this mess the increasing workload an an inept and often incompetent branch of the public service and this is what the outcome is.

Dr   13/02/2023 6:39:32 AM

There 100% needs to be legal ramifications for vexatious/trivial/whatever-you-want-to-call-it complaints. Every complaint needs to be made under Statutory declaration only. I would gladly double my RACGP fees if it meant the medical colleagues would get together to set up a legal team that specifically goes after these types of complainants, and at a minimum go after them for false declaration. We already know paying AHPRA doesn’t do much for us doctors so hopefully the colleges will have our back.

Dr Fahimeh Tabatabaei   13/02/2023 2:11:41 PM

Unfortunately, this is an area that GPS are left alone to deal with, at any cost ( time, money, mental health and etc). Exactly opposite to what would be expected, GPS are on blame for AHPRA unless proven otherwise! while it supposed to be a support provider and protective body. This is so disheartening that GPs being bullied by patients and then trying for months to prove themselves right to AHPRA.

Dr Arnold Dela Cruz   13/02/2023 3:13:24 PM

Keep on asking why pay AHPRA. It is meant to protect the public so why do we why pay and not the public.
We pay insurance because we know when we made a claim we get something back. What do we get from AHPRA?
All the talk that have been happening is frustrating a lot of GPs and we're going nowhere.
We don't even have any avenue to air our grievances to patients. We just put with things and life goes on. We have had enough, we've had enough. Let's do something about it - sooner than later, if not now !!!

Dr RS   13/02/2023 7:19:42 PM

To all that are angry and frustrated with the treatment being meted out by Ahpra to GPs and others, I am sorry to say this- you cannot do anything about it. You have to pay their fee which they will increase when the want ( but rebate rises are not a priority ) they will continue to hound you with trivial and non trivial complaints as they wish, the medical board will inflict more onerus cpd requirements and other responsibilities on you. You can say you have had enough but other than changing professions or moving to another country, you cannot do anything about it! So accept it!

Dr SD   18/02/2023 7:02:35 AM

The whole system is unfair and broken. I have been also been attacked (that's how it feels) by AHPRA with nonsense vexatious complaints in my career.

Abuse towards our doctors and reception has increased from our patients due to lack of staff in our clinic so I guess "here comes another complaint that will have nothing to do with my patient care".

Working for corporates and dealing with unnecessary bullying from beuracracy is not medicine. It is clear to me that I have no rights even as a human being working in this profession. I'm planning to get out from GP land.

Dr UO   19/02/2023 10:41:47 AM

It is very sad to see a doctor receive a letter from AHPRA that sounds and feels like he/she is guilty until proven otherwise.

AHPRA should have a triage system in place and if a complaint doesn’t meet certain criteria the patient should be advised to resolve their complaint directly with the practice ( through the practice manager ) and if there is no resolution it can then be escalated.

This should reduce the amount of complaints AHPRA deals with and hopefully the length of time it takes to resolve complaints.

Dr Khodadad Davari   10/03/2023 5:23:22 PM

I suggested AHPRA to put a 5 dollar fee per complaint. I predicted that this would reduce the number of complaints by at least 30 percent.

Dr KRS   6/06/2024 10:31:28 AM

I am a GP registrar who recently received a HCCC complaint from a patient unhappy with his work cover certificate. I am shocked and disheartened that this sort of complaint was even allowed. I am saddened that I have to defend myself from a position of presumed guilt. It has taken a toll on me while preparing for exams.

I work in a rural community that is already struggling for doctors but I don't plan on remaining a GP anymore. I will leave once I finish GP training to something like urgent care or hospital based work.

Our regulators and college does not protect us with clinical work. Hence the exodus of GPs into medical educator and college based roles or corporate/hospital/urgent care.