Looking below the surface – Reporting a colleague

27 May 2019 | Dr Mark Woodrow, MBBS, MBA, GDAppLaw, GCArts, GCertEM (ACEM), Claims Manager and Medical Advisor, Avant

Making a complaint about a fellow practitioner is no light matter, and yet most doctors would be surprised to hear complaints by another healthcare professional are increasing.

One member was the subject of an Australian Health Practitioner Regulation Agency (AHPRA) complaint by a hospital treating team alleging departure from professional standards, which led to two years of investigation by the Medical Board. The entire process understandably took a considerable toll on the member, emotionally and professionally.

Jumping to conclusions

A GP member had for several years managed a complex patient, who had mental health and medication dependence problems, as well as a number of chronic health conditions and disabilities.

The doctor started weaning the patient off very high doses of opioids and other drugs of dependence with the assistance of a chronic pain team, often battling non-compliance and patient resistance.

The doctor also coordinated the patient’s care between a number of hospitals as well as various specialists, allied health practitioners and carers.

Despite implementing systems to prevent prescription misuse, and while under the supervision of carers, the patient inadvertently overdosed and was taken to hospital.

The emergency doctor and inpatient treating team at the hospital were concerned about the extent of the polypharmacy.

Without discussing the presentation or history with the GP, they notified AHPRA alleging inappropriate prescribing.

In responding to the notification, it was important to comprehensively describe the therapeutic relationship, referrals and prescription history between the GP and the patient, which was well supported by a good clinical record.

We arranged for the doctor to undertake some further education from Avant on opioid prescribing and care coordination, to ensure he was across best practice.

The education and expert evidence in support of the member’s treatment of this complex patient were crucial to the member’s submission.

The Board ultimately came to the conclusion the member had practised within accepted professional standards and made a finding of ‘no further action’.

Be careful passing judgement 

We commonly hear members expressing dismay at the time, cost and effort required to defend what they believe are unfounded accusations from patients. However, many complaints are either made by the patient as a result of another doctor’s criticism of a colleague or made by another doctor themselves. Even where there is a finding of 'no further action', a complaint often has a significant negative impact on the practitioner involved.

This is not to say complaints by peers are unjustified – often a complaint is understandable when viewed from the patient’s or practitioner’s perspective.

A patient's retelling of a previous doctor's care can also sometimes be inaccurate. Issues such as miscommunicating their treatment plan or forgetting to disclose important information can lead to premature judgement of a peer.

Avant recognises complaints have an important role to play to ensure the public is protected from harm. If you are concerned or have questions about the care another doctor has provided, try first to have a discussion with the doctor to establish the facts, looking below the surface before arriving at a conclusion.

Questions to ask yourself or your colleague 

  • Does what the patient reports sound accurate and reasonable?
  • Could there be a misunderstanding, poor recollection or an ulterior motive?
  • Do I truly understand the other doctor’s perspective? Are the facts correct?
  • Do the circumstances meet the criteria for mandatory or voluntary notification?

If you are unsure of your obligations, our resources can help you through the decision-making process. Avant’s Medico-legal Advisory Service also provides members with expert advice on 1800 128 268.

Useful resources

Watch our video Receiving a complaint from AHPRA, or read our factsheets What should I do if I receive a complaint? and Dealing with the stress of a claim or complaint.

This article was originally published in Connect Issue 12.

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