Physicians who face a regulatory authority (College) complaint or an investigation report feelings of anxiety and stress. Gaining a sound understanding of the stress associated with the complaint process can prove helpful to all physicians given that most will be confronted with a College complaint in the course of their career.
Over the years, the CMPA has conducted a number of surveys with members who have received a complaint. These surveys confirm that members consistently suffer significant anxiety — often greater than what they experience when involved in a legal action.
When the complaint escalates to an investigation, physicians' stress can become more intense and turn into distress. The surveys also reveal that the lengthier the College process, be it a complaint or investigation, the greater physicians' stress.
Some physicians have difficulty coping even when the complaint is unfounded and the final outcome is favourable. Many are stressed by what might be perceived as an error or criticism. Physicians express feeling betrayed by patients who launch a complaint and a number admit to feeling ashamed and reluctant to talk about the issue with colleagues or even family members. Some physicians have difficulty sleeping or concentrating, and some slip into depression. Others admit losing confidence in their clinical skills and judgment, regardless of the outcome of the complaint. Some report being devastated. A few consider leaving medicine or changing the scope of their practice to minimize the risk of future complaints. As physicians struggle to maintain normal behaviour, members of their family can be affected as well.
Focusing on the outcome can help
To help address stress, it is important for physicians to understand the complaint process so they can put the complaint in context and maintain perspective. Most physicians face at least one complaint during their careers, and most complaints do not result in disciplinary action or are dismissed outright.
Colleges may identify an area of weakness in the physician's practice and view the complaint as an educational opportunity that benefits the physician. Some Colleges may ask physicians to prepare a document about a particular topic as part of an educational exercise. Other Colleges may ask physicians to meet with a registrar. Some physicians may be required to take a remedial course, such as a medical records training or a communications course, particularly if multiple complaints have identified a need to improve their interactions with patients.
Some College complaints do progress to an investigation into a physician's practice. Approximately 10% of physicians experience serious outcomes such as voluntarily resigning or retiring, having a limit imposed on their practice, or having the matter referred to Committee, which may result in suspension or revocation.
Strategies for coping
Physicians should remember that they are not alone in experiencing the emotional stress of a College complaint and recognize the importance of taking care of themselves. Here are a few points to keep in mind.
Analyse the issue objectively
Viewing the situation objectively and honestly allows physicians to keep the complaint in perspective. Preoccupation with the issue heightens the potential for making an error in their professional and personal life, so physicians must be self-aware and set limits on how much time they spend thinking about the complaint, and then make time to remember all that is going well.
Using the best friend technique allows physicians to treat themselves as they would treat their best friend. If they have made an error, they should allow themselves the same understanding they would accord to others. There is no need for judgment. It is important to learn from what has happened and move forward.
Respond professionally to make improvements
Knowing they have responded professionally in the face of criticism can reduce physicians' stress. They should focus on what can be learned from the complaint as it relates to their practice, their knowledge, and their clinical skills.
Seek personal support
Physicians do not have to go through the complaint process alone. They should stay connected and maintain normal relationships with patients, colleagues, family, and friends.
Seek resources and professional help
Physicians can benefit from seeking professional counselling from their family doctor or accessing the services of a Physician Health Program. A full list of Canadian Physician Health Programs is available on the CMPA’s Physician Wellness page. This page also offers a list of resources for staying well, and easy access to articles and videos addressing key wellness issues. The article "Understanding how Colleges handle complaints or allegations of professional misconduct" can provide helpful information about the College complaint process.
CMPA is here to assist
When a member calls the CMPA about a College complaint, our physician advisors, who are physicians with extensive medico-legal experience, respond with professional and collegial support.
Physician advisors understand the emotional toll of medico-legal events on physicians. They listen to members with an empathetic ear, help put complaints in perspective, and offer significant practical guidance to physicians responding to College complaints. Contacting a CMPA physician advisor when you receive a complaint is an important first step in coping with the stress you may be feeling.
Although the CMPA is able to provide collegial support when facing College complaint, medico-legal defence is generally limited to members facing College complaints relating to the professional practice of medicine. The CMPA will generally not assist with complaints primarily arising from business or personal issues, such as advertising, rental or leasing disputes, employment issues, and marital and family disputes. Early contact with the Association can often alleviate stress for physicians and contribute to a satisfactory resolution.
Through our web resources and compassionate peer-to-peer advice, the CMPA supports physicians who face a College complaint. Call the CMPA at 1-800-267-6522.