Dealing with the stress of a medico-legal complaint
Tuesday, 22 October 2019
Facing a complaint, litigation or a disciplinary hearing is one of the most stressful events a doctor will face and it carries significant professional and personal impacts. Research looking at the psychological wellbeing of doctors (undertaken by psychiatrist Dr Louise Nash from the NSW Institute of Psychiatry) has shown that many doctors describe having a medico-legal complaint as the most traumatic experience in their lives, even when the matter is resolved in their favour1.
With the number of complaints to regulators increasing2, more and more practitioners must deal with at least one at some stage during their career.
While most doctors would prefer not to contemplate this experience, many of the strategies for dealing with a complaint are the ones that also assist in dealing with other stressful events.
It can be difficult to recognise or build the support structures you need when you are already stressed. If you can put in place some support, before you need it, this may make a world of difference to you during challenging times.
The impact
Having your professional competence and reputation questioned can be extremely confronting, and the physical and emotional impact can be significant.
Generally, practitioners facing some kind of complaint or claim are at a heightened risk of both physical and mental illness3.
They are also at greater risk of making mistakes. Even if you think you are fine, it is important to remain aware of your wellbeing and your needs during this time.
Legal processes are often lengthy and frustrating, and it can be easy to catastrophise over the possible outcomes. One of the toughest elements can be the feeling of loss of control over the process or the outcome. This presents a real challenge for doctors who are used to a high degree of professional autonomy.
Practical strategies
One strategy to take back some sense of control is to focus on what you can influence and proactively consider where you want to direct your energy.
When you contact your medical defence organisation, they will often ask you to start putting down in writing your version of events. Many doctors have said they find getting the issue out of their head and onto the page a good way to feel as if they are doing something to get the process of resolving the complaint underway.
It can also be helpful to think about other practical steps you might need to take in your practice. For example, consider whether you need to make changes to your practice to minimise the risk of mistakes during times of stress or distraction. Could you put in place a plan that would allow you to reduce your workload or take leave if you need to deal with other issues?
Recognising strategies that work for you
Consider how you tend to respond to stress. Have you found any coping mechanisms that have helped you manage stressful experiences in the past?
Whatever these are, whether exercise, spending time with friends, walking or finding a quiet space to recharge, it can be easy to let these go in periods of stress. Since these are times when we need them the most, it is really important to try and make the space and time for them.
Avoiding isolation
We always ask what support doctors are getting in relation to the complaint, and it is sadly not uncommon to hear that they have told no-one. It is important not to isolate yourself completely.
Research suggests that doctors who feel supported by their colleagues are best able to manage the stresses of the complaints process4. If you can talk to a colleague or mentor you may be surprised to hear they’ve been through something similar.
It can be helpful to talk about how you feel with those close to you, even if you cannot share specifics due to confidentiality.
Sharing the emotional impact can help lessen the burden and make the process less daunting. It can also help family and friends understand what is going on if the strain does show at home.
Finding the help you need
In an article published in Avant’s Connect magazine5, psychiatrist Dr Kym Jenkins points to the importance of thinking ahead as a strategy for managing all kinds of professional and life stresses.
Dr Jenkins suggests thinking about where you would go for assistance for all kinds of issues, from having the flu to a family crisis, to needing a professional sounding board, being involved in a workplace dispute or receiving a complaint.
Do you know who to talk to, or how to access support networks?
Key contacts
If you do receive a complaint, don’t try to deal with it alone.
There are many support resources available, both personal and professional.
For medico-legal advice and support, contact Avant at nca@avant.org.au or on 1800 128 268, 24/7 in emergencies.
We can also put you in touch with external supports such as the Doctors’ Health Advisory Services.
This article was originally published in the Australasian Gynaecological Endoscopy & Surgery Society escope newsletter in July 2019.
- Nash L, Tennant C, Walton L. The psychological impact of complaints and negligence suits on doctors.
- Australian Health Practitioner Regulation Agency. Annual Reports from 2010/11-2018/19.
- Avant. The impact of claims and complaints on doctors’ health and wellbeing.
- Bourne T, De Cock B, Wynants L, et al. Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional study of the UK physicians.
- Jenkins K. ‘Plan ahead to look after yourself’, Avant, Connectmagazine, issue no 6, p. 5.
Disclaimers
IMPORTANT: This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.
