Insight and reflection needed for a positive outcome

09 June 2020 | Hannah Shiel, LLB, Associate - Professional Conduct, Avant

A complaint made to a health regulator against you can be confronting and overwhelming. However, if dealt with appropriately the best outcome can be achieved, as one member experienced.

Dr Smith* was working in a busy Sydney GP practice and treating a lot of patients, some of whom were not her regular patients.

The patient at the centre of this matter was first treated for wound management by Dr Smith after they were involved in a car accident. They did not attend the practice again until over a year later for treatment of a sore ankle. No fever, headache or any other symptoms were present, so the doctor made a diagnosis of gout.

A few days later Dr Smith received a copy of a discharge summary. The summary noted the patient had been hospitalised for meningitis and had previously had a splenectomy, which Dr Smith was not aware of at the time of her diagnosis.  

A complaint was made to the regulator by the patient's partner citing that because of Dr Smith’s misdiagnosis, the patient had been in hospital for a period of time.

Performance scrutinised

The Medical Council reviewed the complaint and decided to pursue it.

When the Council requested a performance interview and a review of the medical records, Dr Smith, understandably, became very stressed, both leading up to and during the interview. Subsequent to the performance interview the Council had further concerns about the treatment provided, patient management, communication and medical record-keeping, resulting in a performance assessment.

Avant Risk Adviser, Dr Peter Walker says, “the performance process is intended to be educative rather than punitive, with the stated goal primarily of protecting the public.”

“It is a fair process in which doctors’ performance is assessed in person by their peers. However, it is not something that should be approached lightly. Doctors need to work with their lawyers and especially with the risk management team, to prepare and be able to demonstrate the necessary changes have occurred".

Support throughout the process

In the lead up to the assessment, the Avant team worked closely with Dr Smith to prepare for the assessment. The advisers provided individualised educational material to address the areas of practice that required improvement and gave emotional support.

Despite being confronted by the criticism of the patient management, in this complaint, Dr Smith was an exemplary participant in the assessment. Serious reflection and hard work to remedy the identified areas of weakness showed insight and demonstrated improvement. The peer assessors praised Dr Smith after the performance assessment, and no further action was taken.

Don’t take performance assessments lightly

This case highlights that the performance assessment process is rigorous. It requires a significant and serious change in the way doctors practise including, completing education and upskilling in areas of concern to the regulator and improving their clinical records. However, the best outcome is often achieved when the doctor can demonstrate insight and improvement, and everyone works together.

It is important for doctors to take any correspondence received from a regulatory body such as AHPRA, HCCC or the Medical Board seriously, and to always promptly seek assistance from their medical defence organisation, before responding.

The possible outcomes of a performance assessment pathway are serious. They can include conditions imposed on a doctor's registration, and even referral for immediate action which can result in suspension.

The assessment process can last several years and include multiple interactions with the Medical Council. The impact this can have on a doctor's sense of professional and personal integrity and their reputation and ongoing financial security can lead to serious psychological distress.

If you receive a complaint contact us on 1800 128 268 for expert advice on how to respond, available 24/7 in emergencies.

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*All names and some details in the case study have been changed.

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