Each year, the Medical Council considers about 2300 complaints and notifications about medical practitioners in NSW. Complaints cover a wide range of issues, ranging from clinical care and prescribing practices through to concerns about a medical practitioner’s own health or behaviour.
There are a few subjects that come up frequently. These resources may help you avoid a complaint in these areas:
- Treatment: Many complaints are about doctors providing inappropriate or inadequate treatment, failing to correctly diagnose or not identifying a condition early enough. The Medical Board of Australia’s Code of Conduct provides a good overview of issues to keep in mind when consulting with a patient.
If you have missed or been slow to diagnose a condition, indemnity insurers provide useful resources explaining how you may defuse the situation.
- Medications: Patients or their family may believe you made a mistake about the medication you prescribed or be upset if you refused to provide a medication they wanted. Some doctors also find it difficult to say ‘no’ to an insistent patient seeking addictive drugs. Not all complaints about prescribing medications come from patients. Other regulators and health professionals such as pharmacists must notify the Council if they believe a doctor is prescribing in a way that constitutes 'a significant departure from accepted professional standards'. The RACGP has an online guide on prescribing drugs of dependence, while NSW Health explains its requirements when doctors need to prescribe Schedule 8 drugs to people who are drug dependent or require addictive drugs for more than two months.
- Communication: Poor communication between doctor and patient often lies at the heart of a complaint. One of the most common complaints the Council receives about communication is that the doctor has made an insensitive or inappropriate remark. Complaints about treatment are far less likely if communication between doctor and patient has been empathetic and open, the patient felt their concerns were heard, and informed consent was given about any examination or treatment provided. The Medical Board’s Code of Conduct includes some helpful tips in the chapter Working with patients.
- Medical documentation: Poor medical records are frequently encountered in the investigation of complaints, and l can result in a formal finding of unprofessional conduct. Recording comprehensive, contemporaneous notes is not only good professional practice, but can be a powerful defence if a complaint is made about your approach to diagnosis and management. This article is a good guide on how to remain patient-focused while making medical notes.
Poorly written or back-dated medical certificates are another common issue notified to the Council by schools and employers. Please read and follow these helpful guidelines.