“If you want to ruin a doctor’s life, all you have to do is make a complaint against them and walk away. There will be no consequences against you. Certainly 90% of the time the doctor will be found to have done nothing wrong, but you will have ensured that that doctor has a year of utter misery.”
These were the comments of Australian Medication Association (AMA) spokesperson Dr Antonio Di Dio at a recent Senate Committee review of the Australian Health Practitioner Regulation Agency (Ahpra). It is an example of how vexatious patient complaints can affect practitioners, and was the impetus for Ahpra developing a special framework to deal with such complaints in December 2020.
Now, in 2023, the National Health Practitioner Ombudsman (NHPO) is reviewing Ahpra’s ‘Framework for identifying and dealing with vexatious notifications’, examining its effectiveness and whether any unintended consequences have arisen.
Ahpra defines a vexatious complaint as one without substance, made with an intent to cause distress, detriment or harassment to a practitioner. It also notes they can come from anyone including patients, members of the public and other practitioners.
Australian Society of Ophthalmologists (ASO) president Dr Peter Sumich told Insight the organisation welcomed the NHPO’s ongoing independent review launched in June 2022.
“Vexatious complaints are hurtful to the practitioner involved and ultimately a waste of resources,” he said. “They detract from the validity of genuine scrutiny of the profession.”
Sumich said a small number of ASO members have expressed concern about how heavily the framework is balanced in favour of the claimant, and how this has been used to suppress competition.
“These concerns are reflected in the AMA’s submission to the NHPO, a submission which the ASO supports,” he added.
In its submission, the AMA said the general view of the medical profession is that handling of vexatious complaints – and the notification process broadly – must be improved. It said it was imperative Ahpra addresses growing distrust of the regulator among the profession – with minimising the impact of vexatious notifications being a key step in achieving this.
“The introduction of the framework does not mean that work by Ahpra on minimising the impact of and managing vexatious notifications is complete, instead it has been an important initial step,” AMA stated.
Referencing Dr Antonio Di Dio’s Senate Committee comments, the peak medical body said this speaks to one of the significant outstanding issues related to vexatious complaints where people can make a false complaint and face no repercussions regardless of the impact on the doctor’s life.
“The ramifications of a vexatious notification can be mentally and financially damaging to doctors. The more serious the complaint, the more significant the impact on the life of the doctor. For example, a doctor cannot practise without a supervisor should the notification require a supervision order. This can take months to establish. As Ahpra is funded from registration fees, the fact that these doctors pay for the vexatious notification process and the resources it consumes adds to this injustice. The AMA would like to see improvements in the timeliness of managing all notifications, but vexatious notifications in particular.”
In 2017, Ahpra commissioned independent research that took the first international look at vexatious complaints. The report, ‘Reducing, identifying and managing vexatious complaints’, found vexatious complaints account for less than 1% of notifications, and that there is greater risk of people not reporting concerns than of people making truly vexatious complaints.
However, AMA was not convinced of this number.
“We would like to better understand the distinction between notifications that occur now that the framework has been in operation for 12 months,” its submission stated.
“Improving transparency on how vexatious complaints are managed would improve how the profession views Ahpra and its processes. We need to see how the framework has changed behaviour and improved vexatious notification handling. We would like to see this as a driver to improve the framework. The AMA is committed to working with Ahpra to achieve this.”
A case study
Recently, the Royal Australian College of General Practitioners (RACGP) warned that vexatious complaints are “out of control and damaging the morale of GPs across the nation”.
It comes following a poll of 1,290 doctors revealing that 80% of respondents were subjected to what they felt was a vexatious complaint.
“I’m glad to report we are making some headway,” RACGP president Dr Nicole Higgins said. “[Recently] I met with the chair of the Medical Board of Australia Dr Anne Tonkin and she advised that they now have a triage process in place for frivolous complaints to reduce the impact on the clinician. That is great news and I urge them to make sure that this process has an impact.”
RACGP vice president and Queensland chair Dr Bruce Willett outlined his own experience with a vexatious complaint in December 2021 arising from a patient who refused to wear a mask and then became abusive to front desk staff. He asked the patient to sit outside and noted that her behaviour was inappropriate.
“This patient put in a complaint that I had yelled at her, which was not true, and it took 10 months for the complaint to finally be dismissed without action,” he said.
“In that time, it took around 35 hours of writing reports and going back and forth with medical defence and having it constantly weigh on my mind during the working day and at night. Keep in mind that it was my first complaint in three-and-a-half decades of practising.”
The ASO told Insight that a draft report by the NHPO was due by the end of 2022, and a final report is earmarked for completion in early 2023.
“The ASO eagerly awaits the release of this final report and acknowledgement of revised mechanisms that will enable the framework to succeed,” Sumich said.
More reading
Disciplinary history could appear on public register in Ahpra shake up
Ahpra accreditation review to set course for next five years
Ophthalmic sector watchful of Ahpra clampdown on ‘cosmetic surgeon’ title
