Tuesday, April 16, 2024

The Good Doctor’s Blog: "When a Complaint is a Breath of Fresh Air

Blogspot by Dr Emil Shehadeh

BOTH he and his father (Mr x) were registered with me. The father saw one of my salaried GPs for mild to moderate back pain. The salaried GP examined him, not on the couch, screened him for an aortic aneurysm and for prostate cancer, and requested an x-ray of the back. There were no red flags (alarming symptoms or signs). Six months later, he presented with weight loss and was eventually diagnosed with aggressive prostate cancer. The son wanted to know: “ Had the GP examined my father “properly”, would the cancer have been detected earlier?”

I looked through Mr X’s medical records. The GP may not have put the father on the cough, but he did ask the right questions, examine him appropriately, looked for red flags, and investigated appropriately. There was no weight loss at the time of the first presentation, and no urinary symptoms. Indeed his blood tests and x-ray were normal.

I advise Mr X’s son that although it may have looked better to have examined Mr X on the couch, it was neither necessary nor did it have anything to do with the later diagnosis of an aggressive prostate cancer, which by the second visit had spread to the back. To my surprise, Mr X’s son was very gracious and thanked me for the explanation. What was refreshing, was that Mr X’s son was genuinely enquiring rather than complaining. He was not seeking to blame the doctor. He just wanted to know whether his father’ cancer could have been detected earlier.

Why was I surprised? Because statistics show that written complaints against healthcare professionals are on the rise, increasing by 4.6% between 2013 to 2014. Often complainants make assumptions about a clinician, how to examine, how to investigate, and whether a diagnosis can be made with the given data, or whether a desired treatment is justifiable, long before they have given the clinician a chance to explain. Prejudice, which means judging too soon, is a word that perfectly describes this behaviour

This prejudicial behaviour leads to a hostile tone in most complaints, which I have had to handle. What is more incredible is that even where the facts point in the opposite direction, where one has gone the extra mile, some complainants refuse to see sense and stick to their guns. In one case, in which a colleague admitted a patient for suspected cancer, thus sparing them the mandatory two weeks wait, the family maintained their hostile attitude, despite the facts exonerating the clinician.

With that backdrop, Mr X and his well brought-up son, were a breath of fresh air; people close to God. Why do I say close to God? Because I know they were Christians and behaved as one might expect them to. As the famous American writer Dale Carnegie once said “Even god doesn’t propose to judge a man till his last days, why should you and I?” . The lesson is “ contemplate before a complaint.”


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