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