Special Report: Surviving the AHPRA complaints process
Recently, a Melbourne doctor wrote of her cold fear when told she was being investigated by AHPRA. The complaint was dismissed, but she said the process was brutal. “The outcome governs your very identity — you as a caring doctor, you as a caring human being.”
Calling for compassion from regulators, she also called for doctors to share their own experiences. Below, we publish your responses.
Dr Shelley Goodson, Brisbane, QLD
Thank you for your honest article. I write as the wife of a doctor who had a complaint five years ago about an incident back in 2013. It has still not finished. There seems to be no end to ongoing investigations and litigation.
These years have taken a great toll on my husband’s health, which was already fragile at times. He has been majorly depressed for long periods. This has impacted on his work and staff, dragging them down.
If I wasn’t a doctor and hadn’t had a complaint against me many years ago in New Zealand, I would have struggled to understand. I am not sure how other families cope without a medical background.
For us, life would improve for a few months when there was no correspondence from AHPRA and then boom — an email or phone call. I think every annual holiday for the past five years has been an emotional roller-coaster.
It doesn’t matter that you can eventually say you were cleared by AHPRA, you continue to second- guess and mistrust yourself. There are thoughts of getting out of medicine, closing the practice. Medical defence organisations are very supportive, but one knows that in the end, it is a chequebook decision for them.
Any one of us could have this experience. It is horrendous. I quite understand the suicides amongst doctors.
We need to have more support for our colleagues and talk about this openly. Tragically we see it as a stain and keep quiet.
We are human, we all have complications and we all make mistakes.
Dr Maureen Fitzsimon, Cornubia, QLD
I have had three legal matters in nearly four decades of working long hours. And along with those, hundreds of cards, presents and hugs, from grateful patients.
One complaint went on for a year, before it was dropped. Another patient who complained had totally disregarded my documented advice. After six years of legal hell and hundreds of hours of my time, the case was dropped.
My medical defence organisation was mostly excellent.
Although during the first case, when I expressed the same self-doubts and fears as the Melbourne doctor, the lawyer snarked: “You’ll get over it.”
Subsequently, I kept my interactions with them emotionally neutral.
Read more:
- ‘My world fell apart’ – doctor describes her blind fear when AHPRA came knocking
- Meet the former HCCC investigator calling for reform
- Health ministers move to give patients right to appeal AHPRA decisions
Anonymous specialist, Wollongong, NSW
Having to deal with a Health Care Complaints Commission complaint about 12 years ago was the most mental health-threatening thing I have been through in my medical career.
The process took about three months. During that time I was consumed by the complaint, which was about the treatment of a patient I had cared for about five years before. I had no memory of them until I went back and looked through my notes.
The complaint came from a ‘whistle- blower’ nurse who had no direct contact with the case or the patient.
During that time, my every waking moment was spent thinking about the complaint and my response.
I felt that my decision- making and management had been appropriate — something that was backed up by expert opinion when we responded to the complaint. But I kept going over and over it in my head. I developed insomnia for the first time in my life and would lie awake at night unable to get what was happening out of my head.
My clinical decision-making was paralysed. Every time I had to make a clinical decision, I was second- guessing myself and wondering if I was going to be grilled about it in five years’ time.
I seriously contemplated giving up medicine. I learned to dread express post envelopes as that was how the HCCC sent stuff out.
I was eventually cleared, but the final letter from the HCCC said, in effect, “We’ve decided not to prosecute you as we don’t think we will win, but we still think you could have done better”. No apology for the trauma they put me through.
The terminology they used in their correspondence made me feel like a criminal, the references to “prosecutions” etc.
In the big picture of things, this complaint was fairly trivial. It didn’t involve an adverse outcome or harm to a patient. But I truly dread facing another complaint in the future.
Dr Iliya Englin, Toorak, Vic
The closest I came to a serious incident was a warfarin overdose.
We never got to the bottom of why the patient did it, but I had to write a report to the coroner on behalf of the practice. Definitely not the best time of my life, but being in New Zealand, the report was accepted without further comment — especially as the family was adamant that it wasn’t our fault.
It was an incident completely out of the left field, and I drew the following conclusion: We have to be emotionally prepared to receive and handle complaints, which are going to become more frequent. Some will be easy to dispatch, such as when the facts are completely wrong. Some others will be indefensible.
Most will be in the grey zone. It will be obvious that nothing of a serious nature took place, and public servants will be disinclined to think about them in any detail. They will be put to the back-burner and dragged out over years, and few doctors will be exonerated on the basis that the patient is a more reliable witness.
Here’s one important point. Someone said that AHPRA holds one’s living in their hands. Not so.
Read the cases cited in their newsletters and familiarise yourself with what you have to do to lose registration, even temporarily. Decisions by AHPRA and the medical board do get challenged and overturned. That’s why they recently tried to put unsubstantiated complaints online, as a terror tactic.
Dr Chris Atkins, Woodend, VIC
Thank you for writing. I went through a similar experience a few years ago.
I am dually qualified (medically and legally) and felt that my care of the patient who had complained was of an adequate, if not above average, standard.
Eventually the medical board exonerated me. I was well supported by my MDO, and in particular by a senior practitioner at the MDO with whom I had had dealings in my legal role.
Nevertheless, it was a very traumatic experience and greatly affected my confidence for a long time. My heart goes out to this doctor.
Dr Nicholas Cooke, Cottesloe, WA
Thank you for sharing. Unwarranted complaints have a very real morbidity and mortality. What you have felt is felt by many.