BMJ 2015;350:h1439 doi: 10.1136/bmj.h1439 (Published 18 March 2015)
Page 1 of 1
Letters
LETTERS SUICIDE WHILE UNDER GMC INVESTIGATION
Preventing, rather than treating, stress in doctors under investigation Maria C Jalmbrant clinical psychologist Lewisham Adult ASD and ADHD Service, Ladywell Unit, Lewisham University Hospital, London SE13 6LH, UK
Hawton comprehensively summarises Sarndrah Horsfall’s internal report for the General Medical Council and expresses confidence that a separate health system will support doctors under investigation who have mental health problems, thereby preventing suicides.1 2 However, this initiative is unlikely to ameliorate the immense stress some doctors experience when subjected to complaint investigations and GMC procedures in particular.
Professor Terence Stephenson recently predicted that most doctors will face a GMC complaint at some point in their career.3 Although most complaints will be unsubstantiated, these investigations can have far reaching consequences, including lost earnings, lost professional status or reputation, anxiety, depression, insomnia, relationship difficulties, social isolation, suicidal ideation, and death. Such occupational hazards are not acceptable, regardless of the quality of the treatment afterwards. Rather than treating the symptoms, we need to prevent them occurring. Several factors may contribute to the stress. Our study of 7926 UK doctors showed doctors would welcome a strict time limit on complaints processes, appropriate resourcing of investigations, and clearer and transparent communication.4 Many doctors felt that they were assumed guilty until proved otherwise and called for this to be reviewed. Many wanted to be able to seek redress for vexatious complaints.
Provision of a support service for doctors is laudable, if both its funding and actions are independent of the GMC. However, the real issue is that there is simply no justification for doctors to be made sick by poor processes—whether by the GMC, hospital trusts, or others, particularly now that we have data that show the risks. The glib statement that such processes are “inevitably stressful” understates the impact of these processes on doctors and may lead to patient care being compromised through defensive practice and a distressed and demotivated workforce. Competing interests: None declared. Full response at: www.bmj.com/content/350/bmj.h813/rr-2. 1 2 3 4
Hawton K. Suicide in doctors while under fitness to practise investigation. BMJ 2015;350:h813. (13 February.) Horsfall S. Doctors who commit suicide whilst under GMC fitness to practice investigation: internal review. General Medical Council, 2014. www.gmc-uk.org/Internal_review_into_ suicide_in_FTP_processes.pdf_59088696.pdf. Lind S. Doctors need resilience training like soldiers in Afghanistan. Pulse 2015. www. pulsetoday.co.uk/your-practice/practice-topics/regulation/doctors-need-resilience-traininglike-soldiers-in-afghanistan-gmc-head-says/20008855.article#.VO5KuUv5n1o. Bourne T, Wynants L, Peters M, et al. The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey. BMJ Open 2015;5:e006687.
Cite this as: BMJ 2105;350:h1439 © BMJ Publishing Group Ltd 2015
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
Letters
LETTERS SUICIDE WHILE UNDER GMC INVESTIGATION
Preventing, rather than treating, stress in doctors under investigation Maria C Jalmbrant clinical psychologist Lewisham Adult ASD and ADHD Service, Ladywell Unit, Lewisham University Hospital, London SE13 6LH, UK
Hawton comprehensively summarises Sarndrah Horsfall’s internal report for the General Medical Council and expresses confidence that a separate health system will support doctors under investigation who have mental health problems, thereby preventing suicides.1 2 However, this initiative is unlikely to ameliorate the immense stress some doctors experience when subjected to complaint investigations and GMC procedures in particular.
Professor Terence Stephenson recently predicted that most doctors will face a GMC complaint at some point in their career.3 Although most complaints will be unsubstantiated, these investigations can have far reaching consequences, including lost earnings, lost professional status or reputation, anxiety, depression, insomnia, relationship difficulties, social isolation, suicidal ideation, and death. Such occupational hazards are not acceptable, regardless of the quality of the treatment afterwards. Rather than treating the symptoms, we need to prevent them occurring. Several factors may contribute to the stress. Our study of 7926 UK doctors showed doctors would welcome a strict time limit on complaints processes, appropriate resourcing of investigations, and clearer and transparent communication.4 Many doctors felt that they were assumed guilty until proved otherwise and called for this to be reviewed. Many wanted to be able to seek redress for vexatious complaints.
Provision of a support service for doctors is laudable, if both its funding and actions are independent of the GMC. However, the real issue is that there is simply no justification for doctors to be made sick by poor processes—whether by the GMC, hospital trusts, or others, particularly now that we have data that show the risks. The glib statement that such processes are “inevitably stressful” understates the impact of these processes on doctors and may lead to patient care being compromised through defensive practice and a distressed and demotivated workforce. Competing interests: None declared. Full response at: www.bmj.com/content/350/bmj.h813/rr-2. 1 2 3 4
Hawton K. Suicide in doctors while under fitness to practise investigation. BMJ 2015;350:h813. (13 February.) Horsfall S. Doctors who commit suicide whilst under GMC fitness to practice investigation: internal review. General Medical Council, 2014. www.gmc-uk.org/Internal_review_into_ suicide_in_FTP_processes.pdf_59088696.pdf. Lind S. Doctors need resilience training like soldiers in Afghanistan. Pulse 2015. www. pulsetoday.co.uk/your-practice/practice-topics/regulation/doctors-need-resilience-traininglike-soldiers-in-afghanistan-gmc-head-says/20008855.article#.VO5KuUv5n1o. Bourne T, Wynants L, Peters M, et al. The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey. BMJ Open 2015;5:e006687.
Cite this as: BMJ 2105;350:h1439 © BMJ Publishing Group Ltd 2015
[email protected] For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
