Receiving a complaint, even if it results in no further action, can be a highly stressful event in a doctor’s career. Understanding the process can help you navigate this challenging event. In this article we look at the process, time frames and support you have available to you when you are the subject of a complaint. 

Our most recent annual report shows about 6% of the state’s 40,356 doctors had a complaint or notification made about them in 2022/2023.[i] Of the 3078 complaints referred to the Medical Council, 84% were discontinued at initial assessment or resulted in no further action.

While this may seem statistically small, the chances of receiving a complaint during your career are not unreasonable.

Understanding what happens, especially at the initial stages of a complaint, can go a long way to helping you better manage what can be a difficult time.

What happens if a complaint is made? 

Usually, the first point of contact will be the Health Care Complaints Commission (HCCC) which is responsible, along with health professional councils, for assessing complaints about health practitioners in NSW. The HCCC will advise you that it has received a complaint and is making an initial assessment.

The HCCC is required to undertake an initial assessment of the complaint within 60 days. In most cases, you will be sent a copy of the complaint and be asked to provide a response. There is always more than one side to the story, so take this opportunity to present yours. You may be asked to provide a copy of the patient’s medical records or other material.

During this time, you may not hear much from the HCCC, this is completely normal. Once the assessment is completed, the HCCC and the Medical Council consult as to whether the complaint should be discontinued or requires further action. This could include providing comments to the doctor, referring for complaint resolution, referral of the complaint to the Council or investigation by the HCCC.

If you are the subject of a complaint, waiting for an outcome can be challenging, especially when you are uncertain as to what is happening. Understanding this process can help reduce anxiety and uncertainty.

Read all correspondence sent to you as it may provide a better understanding of the processes.

If the complaint is referred to the Medical Council following assessment, you will be advised in writing. Once a case manager has been allocated to the matter by the Council, who will be your point of contact, more detailed information will be provided to you on next steps.

The Council will consider whether further action is deemed necessary. These decisions are made by Council Committees made up of representatives of the medical profession and community members to ensure all perspectives are considered.

You can read more about the Council’s processes for assessing complaints, here.

How does the Council decide if action is needed?  

When the Council assesses a complaint, it considers:

• what happened
• the doctor’s response to the complaint, and any other relevant information (including information from other parties and previous complaints)
• the seriousness of the incident
• the doctor’s ability to reflect on what happened and show that they understand expected standards
• what the doctor has done to ensure that a similar incident does not recur
• if related to a health notification, the impact of the doctor’s health on their practice

In some cases, further information may be needed (e.g. a further response to the issues raised in the complaint). In other cases, an assessment may be needed (e.g. a practice-based assessment of a doctor’s performance, or an independent health assessment). It may be that a hearing is required to consider all information prior to a decision being made. These are all opportunities for you to engage with the process and share your side of the story, as well as your reflection on the complaint and lessons learnt.

It’s important to know that further action by the Medical Council is not punitive. Its primary focus is to identify if a doctor’s conduct, health, or practice is putting the public at risk. If so, the Council will work with the doctor to put in place safeguards, to protect the public and, in doing so, address the areas of a doctor’s practice that require remediation or rehabilitation.

This might include placing conditions on a doctor’s registration until such time as the doctor has demonstrated there is no risk to patient safety. Registration conditions might include reducing the number of patients a doctor sees, or restricting the type of surgery they can do, or require alcohol and drug testing. In a small number of cases the Medical Council may take urgent action because the risk to the public is immediate and suspend a doctor or impose conditions within weeks of a complaint or notification being received. These decisions are not made lightly and are made by delegates of the Council. Delegates include highly experienced medical practitioners and community representatives.

For a more detailed understanding of the complaints process, visit the Medical Council website. 

You don’t have to go it alone

We know that receiving and responding to a complaint can be a highly stressful experience. This is particularly true in the initial 60 days when the HCCC is undergoing its assessment. With no indication of what will happen at this early stage, waiting for the assessment to be completed, can be quite stressful. It can also give rise to a sense of worry and shame that can stop a doctor from speaking with others or seeking support.

Sharing the experience with someone you trust not only relieves some of the burden of the process but can assist you in your learning and reflection. From the moment you are advised of a complaint, there are people, including other doctors, that you can speak to. You should also contact your medical indemnity insurer immediately, as they are a vital partner in this and can assist you in understanding what is happening, what to do, and how to respond.

Depending on your practice, you can also speak to:

• the complaints manager of your facility or local health district
• a lawyer or legal representative
• your professional association
• a trusted colleague or support person

Confidential help

If you would prefer to speak to someone confidentially for support, there are also specific support services for doctors including:

• Doctors’ Health NSW, an independent and confidential service for doctors, 02 9437 6552
• Medical Benevolent Association of NSW-ACT, 02 9987 0504
• Black Dog Institute
• Drs4Drs 1300 374 377 (the national body that will direct you to the relevant state or territory doctors health service)
• The RACGP GP support program, 1300 361 008

Remember, self-care is always important

If you don’t have a regular GP, take active steps to find one to support your own self-care. The AMA NSW’s Doctors for Colleagues website has a list of GPs who treat other doctors and who can refer you for further support. You can find this list of doctors here.

Key takeaways

• Most complaints received will be discontinued or require no further action
• Don’t ignore the complaint. Engaging with the process can be very helpful
• If you receive a complaint, contact your medical indemnity insurer straight away
• Make use of free and confidential services

References:

[1] Our latest annual report - What you need to know | Medical Council of New South Wales (mcnsw.org.au)