Complaints unhelpful say doctors

By REBECCA WALSH

About half of doctors believe medical complaints against them do nothing to improve the standard of medical care in New Zealand, a survey shows.

The survey, published in the New Zealand Medical Journal today, showed nearly all doctors supported people's right to make formal complaints but 40 per cent believed most medical complaints were unwarranted. Another 50 per cent were neutral. Only a third of the 598 doctors believed complainants were "normal people".

Author Dr Wayne Cunningham, a senior lecturer in general practice at the Dunedin School of Medicine, said doctors were not asked specifically what they meant by "normal" but previous questions indicated doctors believed some patients had "an axe to grind" or had psychiatric problems and were not representative of their patient base.

Dr Cunningham said for some doctors a complaint was "like water off a duck's back" but others felt anger, depression, shame and guilt. Some contemplated suicide. He knew of one doctor who committed suicide not long after a complaint was made.

Many doctors were concerned about the length of time it took to settle complaints and questioned whether they were judged by appropriate standards.

"I was devastated by the length of time it took to resolve. I contemplated suicide, leaving the profession, leaving New Zealand etc. It was a very terrible time of my life and for many years it was very difficult to talk about it," one doctor said.

Dr Cunningham said about half the doctors believed complaints were not about errors and wrongdoings. They believed complainants were not acting to reduce the risk of a bad event happening to someone else.

It appeared doctors were "by no means sure" that the quality of medical care delivered to patients was improved by the complaints system.

"Doctors are well aware of the complexity of practising and the tensions between the limitations of medicine and the expectations of society. They also recognise the tensions between the rights and responsibilities of doctors and patients. However, there is no evidence that complaints improve the delivery of patient care," Dr Cunningham said.

In an editorial in the same journal, Health and Disability Commissioner, Ron Paterson said emerging evidence showed that, instead of providing reconciliation and closure, complaints could have "toxic effects" on patients and doctors.

The HDC's 2004 survey of complainants using its services showed that only 46 per cent were satisfied with the overall fairness of the process (compared with 80 per cent of providers).

Mr Paterson said the finding that most doctors did not view complaints as a "good thing" was "like children asked if they like Brussel sprouts".

But he said the "disturbing" finding that only a third of doctors believed "most complainants were normal people" was "at variance" with his experience of the sort of people who complained to the HDC.

The study found doctors favoured a "one stop shop" for handling complaints which focused on doctors' education and improving systems of delivery of care.