Communities are short of doctors. As the medical workforce ages, keeping more experienced, older doctors working for as long as usefully possible seems a good idea. Those nearing retirement may face proportionally more complaints and registration dilemmas. Will they simply ‘exit right’ because it’s all too hard?
Background Information
CPD and credentialing requirements vary for the doctor winding back, depending on their past experience and whether they want to do bush locums or suchlike. Becoming a professor is trendy but registration for academics cutting back clinical practice still poses questions.
Because a complaint could be ‘the straw that broke the camel’s back’ we asked doctors (E-poll – see inset) what they considered were indicators of fairness in handling complaints between health professionals, assuming this would filter out vexatious complaints.
Interestingly, doctors seem to suggest our investigators need some credentialing of their own, and they should be quick on their feet in determining if a complaint has merit. But should these investigators be lawyers, doctors or someone else?
This is an important question because indications are that the people involved now are making a meal of it – seemingly taking too long and investigating everything in-depth. More than 80% of AHPRA complaints were found to have no merit, according to the last annual report, something that is reflected in our MDOs fielding a steep rise in member requests for assistance. Is the public interest better served by this new system?
Are state-based medical boards, still thriving since we went national, being handed poorly worked-up cases by AHPRA for panel hearings? AHPRA now has $25m at its disposal from registrations of all health disciplines to fund its activities. Early determination as to whether a complaint has merit and low level complaints settled early through mediation, were priorities for our polled WA GPs, specialists and trainees.
Most of the approved medical board panellists from WA, appointed anonymously to adjudicate on matters, were transitioned from the old system to sit on either a Health Panel or Performance & Professional Standards Panel. It is AHPRA staff who choose suitable panellists to hear a matter, subject to availability, their expertise and declared conflicts of interest. Panellists from interstate are meant to be chosen, presumably to avoid complaints of bias.
If you work in a public hospital in WA, response to an internal complaint may appear worse (see letters, this edition). There is a Memorandum of Understanding negotiated between HDWA and the AMA as a guide for handling complaints but there is no requirement for this to be followed. In the interest of fairness, there should be, especially if it means a complaint’s merits can be properly determined at a local level before it goes before more distanced committees and individuals. As an aggrieved doctor you may not get justice until you eventually take everyone to Court, and no one comes away from that experience a winner.
Fairness in Handling Complaints
A total of 250 doctors offered opinions – GPs 43%, Specialists 37%, Doctor in Training 14%, and Other 6%
ED. The DIT figures mainly from hospital-based doctors are likely to apply to HDWA complaints procedures, rather than AHPRA, so the variance in figures (highlighted) gives some idea of their particular concerns.
| All | GP | Spec | DIT | |
| Those investigating are skilled/trained in conducting a fair investigation. | 64% | 59% | 63% | 80% |
| Early assessment of whether a complaint has merit. | 58% | 66% | 52% | 46% |
| Ability to resolve low level complaints early, through mediation. | 53% | 58% | 50% | 49% |
| Complaint dealt with promptly. | 51% | 45% | 58% | 51% |
| Privacy for both parties until complaint progresses to the disciplinary body. | 48% | 50% | 47% | 40% |
| A known, compulsory pathway in dealing with a complaint | 20% | 15% | 23% | 29% |
| Other point. | 1% | 1% | 0% | 0% |