Colleagues are best source of support for doctors
facing complaints, researchers find
Abi Rimmer
BMJ
Doctors facing a complaint have lower levels of depression and
anxiety if they seek support from their colleagues, research
published in BMJ Open has shown.
1
UK and Belgian researchers concluded that denying doctors the
chance to speak to colleagues, as may happen in serious cases,
is unreasonable, as having the support of colleagues as well
as management was associated with less avoidance and
psychological morbidity. Avoidance can include avoiding
some procedures, not accepting high risk patients, and
abandoning procedures early.
The researchers sent an online survey to 95 636 BMA members
to find out whether depression, anxiety, and defensive practice
were associated with the support that doctors sought during
complaints processes. They received 7926 responses (an 8.3%
response rate), including 6144 from doctors who had faced a
complaint.
The researchers found that most doctors (61%) who had faced
a complaint felt supported by colleagues, while only 31% felt
supported by management. And the doctors who spoke to
colleagues about the complaint against them had the lowest risk
ratios for depression and anxiety, they found.
Depression and anxiety were more common in doctors who
reported speaking to family or friends about their complaint,
doctors who engaged independent legal advice, and those who
accessed support from the BMAs employment advice service
or a BMA counselling service.
The study authors wrote, When doctors reported that they spoke
to colleagues, they were significantly less likely to suffer from
anxiety and depression, although it must be acknowledged that
it is possible that doctors who are more anxious inherently find
it more difficult to speak to colleagues.
The survey also found that most doctors (78%) thought that the
complaints process had been needlessly protracted. Nearly half
(49%) of respondents said that the system had been used
inappropriately or vexatiously, and 32% said that managers had
used a complaint to undermine them.
Just under a quarter (24%) of respondents thought that a
colleague had used a complaint to take advantage of them, either
financially or professionally.
The researchers also found that around half of the respondents
(54%) had never displayed avoidance behaviour and that 16%
had never displayed hedging behaviour, which includes
performing more tests than necessary, over-referral, and
overprescribing.
Hedging was greatest when doctors spoke to family or friends
and when they accessed help from medical professional support
organisations, the researchers said.
They wrote, No clear relationships were found between
perceived support and hedging. Generally, process-related issues
were not strongly associated with hedging, although a protracted
timescale for a complaints process was a factor.
1 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 survey of the UK physicians. BMJ Openhttp://bmjopen.bmj.
com/content/7/11/e017856.
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BMJ 2017;359:j5420 doi: 10.1136/bmj.j5420 (Published 22 November 2017) Page 1 of 1
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