AHPRA notifications: A junior doctors guide

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In the past year, I have been subject to two notifications via AHPRA. This seems to be a trend across Australia, with numbers of complaints/notifications rising. A recent Age article demonstrated this and some of the predictive factors. For a junior doctor like myself having only practiced for three full years, it was like getting hit with a truck full of bricks. Of course I won’t to go into details, but suffice to say nothing permanent gone onto my record. However in both cases (one being from a parent in a tertiary ED and the other from another doctor), I have learnt a great deal. Yes the medical board is there to protect the public, but both times I had the feeling of having to prove my innocence, not the other way around. I’m sure that it is more the way my mind appreciated the situation rather than the intended effect of the process, but it certainly feels for want of a better word…shithouse.  The length of time taken for each issue was also appalling. It took at least 4-5 months from initial notification to final outcome. This is something that the big GP stakeholders have recognised in this article via Medical Observer. It is something that I would not wish upon anyone, but if you find yourself there…here are my tips:

Take good notes

In both cases, I was lucky to have written good contemporaneous notes that I was able to look back on. They not only helped me remember the particular case, but also to demonstrate that I am a competent clinician to the board. I could not imagine being hauled up and not have sufficient details to help explain my actions. Take good notes, its a must.

Contact your MDO

In trouble for that mo!

In trouble for that mo!

Again on both occasions, my first phone call following the notification was to my medical defence organisation. They helped set up a file, had their team look over the case and help me draft a response. Although some doctors may feel comfortable handling the response themselves, I certainly had immense support from my MDO during what is a difficult time. You will save a lot of hassle if you wish to defend yourself from any action the board may take if your MDO is on board from the get go.

Explain your situation

When it comes to writing your response, make sure that you let the reader know the situation you are working in. That might be an overcrowded or busy ED, rural location without support, walk up clinic and everything in between. Without coming across apologetic, if you at least provide some background, the board can put your situation in context.

Ask for support

Often your character or actions will be disputed by the complaint. Fight back! You know yourself the sort of doctor you are and why you joined the profession. If you have collegues that can appropriately support you in writing, do it. These are the people that know best how you work day to day. Not a single patient, family member or doctor you’ve never met.

Debrief

Talk with someone about the situation. Even though I would consider myself a moderately resilient person, when you get that first phone call or letter, your heart sinks. Here you are practicing in a profession that aims to improve the health of others and the big stick gets pointed at you. For me I felt many emotions both times, often all at once! In order to continue practicing and maintain a love of doctoring, I needed many chats with close friends and collegues. I also needed to keep working. The patients that thank you for your time and help can certainly heal a bruised ego. Unfortunately it only takes those one or two complaints (whether justified or not) to damage a whole day of grateful patients.

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6 Comments

Filed under AHPRA, Emergency Medicine, General Practice, Health Policy, Rural GP

6 responses to “AHPRA notifications: A junior doctors guide

  1. Yes very wise, Gerry. I think most of us would know the hurt that comes from a patient complaint / report when we are really just trying to do our best for the great mass of humanity who come through our doors. It’s particularly awful when the ones who complain are the ones that you’ve tried extra hard for.

    I had a complaint from a kid’s parent in ED overnight because I hadn’t prescribed the treatment she demanded because it wasn’t medically indicated. The irony is it would have been much easier to give the damn script and not waste half the night trying to educate and explain why the kid didn’t need it AND I would have spared myself a complaint. I got good support from my supervisor at the time and agreed that detailed notes were hugely helpful. The other feedback that I got from the boss was that when a patient seems unhappy or disgruntled, worth getting (and documenting) a second opinion to help cover yourself later.

    • Thanks for the comments Penny, nice to know Im not alone in feeling that way! Second opinion is a great one, will add to the post. Have been loving your blog too :)

  2. Well looks like Queensland will have four regulators – AHPRA, the Queensland Medical Board, the Health Ombudsman and the Health Quality and Complaints Commission. It will be interesting to see how 4 different bodies will pick the Wheat from the Chaff – interesting times….

  3. Craig

    Very much like policing… I had numerous complaints without ever any found to have substance…but the stress involved is still the same.

  4. Hello, thanks so much for your post. I have just been talking to midwives about this issue in my role of professional officer for the Australian College of Midwives. I couldn’t agree more with your advice about documentation, and it certainly doesn’t do any harm to have a second person witness your conversations etc. Thanks for your honesty…I’ll be passing this post on as learning too to midwives. cheers Sarah

    • gerryconsidine

      Thank you for the comments Sarah! I’m glad some of the advice may be applicable to other fields. Feel free to pass on and share. Cheers

      Gerry

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