Dealing with the stress of a medico-legal complaint

23 October 2019 | Georgie Haysom BSc, LLB (Hons) LLM (Bioethics), GAICD, Head of Research, Education and Advocacy, Avant

It’s 3pm on Friday afternoon when you open an email from the regulator. The email informs you that a patient has complained that her recent hysteroscopy was poorly performed, and as a result she has been suffering ongoing pain and bleeding. She also claims you were rude and condescending during the consultation.

For doctors, there are few things as stressful as receiving a complaint or claim and the process can affect many aspects of your life. With the number of complaints to regulators increasing1, more and more practitioners have to deal with at least one at some stage during their career.

While most people would prefer not to contemplate this experience, many of the strategies for dealing with a complaint are the ones that also assist in dealing with other stressful events. It can be difficult to recognise or build the support structures you need when you are already stressed. If you can put in place some supports, before you need them, it may mean a world of difference to you during stressful times.

The impact

Having your professional competence and reputation questioned can be extremely confronting, and the physical and emotional impact can be significant.

Generally, practitioners facing some kind of complaint or claim are at a heightened risk of both physical and mental illness2. They are also at greater risk of making mistakes. Even if you think you are fine, it is important to remain aware of your wellbeing and your needs during this time.

Legal processes are often lengthy and frustrating and it can be easy to catastrophise over the possible outcomes. One of the toughest elements can be the feeling of loss of control over the process or the outcome. This presents a real challenge for doctors who are used to a high degree of professional autonomy.

Practical strategies

One strategy to take back some sense of control is to focus on what you can influence and proactively consider where you want to direct your energy.

When you contact your medical defence organisation, they will often ask you to start putting down in writing your version of events. Many doctors have said they find getting the issue out of their head and onto the page a good way to feel as if they are doing something to get the process of resolving the complaint underway.

It can also be helpful to think about other practical steps you might need to take in your practice. For example, consider whether you need to make changes to your practice to minimise the risk of mistakes during times of stress or distraction. Could you put in place a plan that would allow you to reduce your workload or take leave if you needed to deal with other issues?

Recognising strategies that work for you

Consider how you tend to respond to stress. Have you found any coping mechanisms that have helped you manage stressful experiences in the past?

Whatever these are, whether exercise, spending time with friends, walking, finding quiet space to recharge, it can be easy to let these go in periods of stress. Since these are times when we need them most, it is really important to try and make the space and time for them.

Avoiding isolation

We always ask what support doctors are getting in relation to the complaint, and it is sadly not uncommon to hear that they have not told anyone. It is important not to isolate yourself completely. Research suggests that doctors who feel supported by their colleagues are best able to manage the stresses of the complaints process3. If you can talk to a colleague or mentor you may be surprised to hear they’ve been through something similar.

It can be helpful to talk about how you feel with those close to you, even if you cannot share specifics due to confidentiality. Sharing the emotional impact can help lessen the burden and make the process less daunting. It can also help them understand what is going on if the stress does show at home.

Finding the help you need

In an article published in Avant’s Connect magazine4, Psychiatrist Dr Kym Jenkins points to the importance of thinking ahead as a strategy for managing all kinds of professional and life stresses. Dr Jenkins suggests thinking about where you would go for assistance for all kinds of issues, from having the ‘flu to a family crisis, to needing a professional sounding board, being involved in a workplace dispute or receiving a complaint.

Do you know who to talk to, or how to access support networks?

Key contacts

If you do receive a complaint, don’t try to deal with it alone. There are many supports available, both personal and professional.

For medico-legal advice and support, contact us at nca@avant.org.au or on 1800 128 268, 24/7 in emergencies. We can also put you in touch with external supports such as the Doctors’ Health Advisory Services.

This article was originally published in the Australasian Gynaecological Endoscopy & Surgery Society escope newsletter in July.

1 Australian Health Practitioner Regulation Agency. Annual Reports from 2010/11 - 2017/18 and Australian Health Practitioner Regulation Agency. Available at www.ahpra.gov.au/Publications/Annual-reports.aspx

2 Avant. The impact of claims and complaints on doctors’ health and wellbeing.

3 Bourne T, De Cock B, Wynants L, et al. Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional study of the UK physicians.

4 Jenkins K. ‘Plan ahead to look after yourself’, Avant, Connect magazine, issue no 6, p. 5.

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