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Complaints and Resolution. Introduction. Some stories … and Principles and practices And disagreement Process feedback. Not all cases are the same – serious conduct, competence and health complaints to frivolous complaints Require individual judgement and discretion in how they are managed
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Introduction • Some stories … and • Principles and practices • And disagreement • Process feedback
Not all cases are the same – serious conduct, competence and health complaints to frivolous complaints • Require individual judgement and discretion in how they are managed • But there are principles we can apply and review
Case One • Doctor convicted of historical and recent sexual assault of patients • Bail granted until sentencing • Should be practise in the meantime?
Case Two • Doctors go on strike – no services provided • 15 deaths attributed • Policy developments – essential services; ethical responsibilities; fair process for negotiations • What should happen to the individual doctors?
Case Three • Doctors suspect colleague of misconduct – knickname of “fingers” • Not reported • Serious negative patient outcomes
Great discussion Strong agreement / some disagreement on principles and practices Pulled out key points
“Ultimately accountability to the public is highest priority” Re-occurring issue – (but some disagreement) “must have legislation that allows MRAs to revoke a license on an emergency basis for egregious or dangerous behaviour” What happened in Case One? Accountability to the public
And there is accountability to the doctor “The doctor must receive a copy of the complaint in order to know what he / she is accused of” “… and it must be timely” Case Two – if we are going to place restrictions on a doctor (whether individual or societal) they have a right to a fair process Accountability to the doctor
One MRA talked about 300 immediate suspensions 60 investigations did not result in a serious finding But 240 did So what is the correct balance? Balancing the two accountabilities
Does accountability to the public also mean their involvement? “Public perception of process is important” “Essential to have public be part of the process” Some examples – is one model better than the other? Public engagement
What is our paradigm for MRAs? “Self regulation is a responsibility to the profession. There is a privilege to self regulation. “Every professional has an obligation to report any problem they see with a fellow doctor …” What would you have done in Case Three? Is self regulation consistent with public engagement or do we really mean independent regulation in partnership? What is self regulation?
Transparency and openness of information – what do these mean? “Balance confidentiality of a doctor’s information with public’s right to know” – is this across all areas – conduct, competence and health? How does this get applied in practice? A detailed report to the complainant? A letter summarising? What information do we share with the public?
“Hearings should be public even if it runs the risk of damaging a doctor’s reputation” “Make complaints public only after charges laid” “Doctors should keep name suppression unless there is a ongoing risk the public has to know about” Is there a difference between a disciplinary model and a rehabilitative model? Openness when?
Complaints help us review not just a doctor but also the system the doctor is working in Various concerns expressed about non-serious complaints and the impact on the doctor – but do they all need investigation or can they be triaged We need to be proportionate in how we manage complaints but not put roadblocks in the way of complainants “Let the public know how to make a complaint and explain the process by whatever means available” Importance of complaints
MRAs rely on information when licensing a doctor “There is a need for an international database for physician discipline so that a centralised hub of information exists for all MRAs to access as new physicians seek licensure in their jurisdictions” Primacy of public protection vs privacy of physician information Importance of information
“Include public and patient representatives to contribute their knowledge and views on good practice” “How can we increase communication between IAMRA conferences?” Interactive website; newsletters Standardised glossary of definitions “We are only as strong as each other” Some of your feedback
