2. In psychiatry we are often trying to make a decision where there is little data to guide us… and where the research is changing rapidly.
3. Most doctors who have had complaints against them take them seriously. Complaints generally make docs less confident, more scared or defensive (which is generally a bad thing) and much more mistrustful of patients (which is a very bad thing).
4. A number of patients make repeated complaints to authorities. Psychiatry and GP collect these kind of patients.
5. There is a duty on all doctors to protect the public, which can include asking colleagues, ones employer, and at times the medical council for backup in getting that doctor back to competence.
6. If one still believes that these sites are worthwhile, I suggest you look at NHS Blog doctor and the hell many GPs there have gone through due to anonymous complaints from patients.
The Health and Disability Commissioner has done, in my view, managed to hold the balance between identifying issues that need correction and avoiding “naming and shaming”.
A return to that state would lead, again, to all health professionals being silent about poor practice out of fear of the inquisitors: which is what Mr Taylor will get if this type of site remains, whether he wants it or not.
The author of Psychwatch argued back that he is doing a public service.
Macdoctor:
You demonstrate a rather tiring yet quite familiar arrogance of the medical field – you believe that a medical degree and the authority to prescribe somehow make you more “right” than anyone else. I mop after you pricks all of the time – your profession is often allergic to correction, blind in your professional hubris, and have a seeming inability to understand any client intervention outside the scientific realm. I understand ethics, as my reference point is codes of ethics, and thus I can quite easily discern between ethical vs unethical behaviour; I can discern between competent and incompetent care, as my reference source is best practice protocols, protocols your own industy creates; if you truly believe that you are unqualified to determine either of these professional markers in your colleagues, then that either makes you an apologist for incompetence or a coward.
You choose.
I notice you have nothing to say about the pathology of depression? Glasser = 1; Medical Fraternity = 0.
I do not the arrogance leaking from this comment… but Psychwatch is wrong…
1. These things (complaints) can literally drive doctors to suicide. (Dr Rant is talking about the UK General Medical Council, and one hopes that the kiwi medical council is more merciful.) However, bullying and patient intiated aggression, including vexatious complaints, exist in New Zealand. I will add that the findings around patient complaints have been found repetatively, most recently in (untrained) caregivers for NGOs: (presenting a poster on this recently at TMHS in Auckland, I was buttonholed by a consumrer who said it was all the caregivers fault).
The great Dr Crippen was campaigning earlier this year about a similar site in the UK. He notes:
My greatest worry about this website is the effect that it might have on a doctor suffering from depression. Do not get me wrong. If you think your doctor is mentally ill, or performing dangerously, not only is it your right to make a complaint, it is your duty so to do. You must take immediate action. But not by making anonymous remarks on the internet. Talk to one of the other doctors in the practice or to the chief executive of the hospital. But do not put some anonymous, wounding criticisms on an internet website. Supposing you are the person who made the above comment. Supposing this doctor is depressed and therefore not performing well. Supposing your anonymous comment tips him over the edge. You read in the paper next week that he has committed suicide. How would you feel then? Do you remember this:
TRURO An out-of-hours GP killed himself because of fears that he might be dismissed after turning up in the wrong town for an emergency call. (full story here)
Who is Dr Neil Bacon to set himself up in judgement over the medical profession? He has no legal training. He has not completed his higher medical training. Whatever he may say, it is hard to believe that his motives are altruistic. This website is a disgrace.
2. Naming and blaming implies that the doctor is disposable. Doctors, nurses and other workers do not hang around when they are unwanted. At the moment New Zealand is benefiting from this: the NHS has made many junior doctors feel unwelcome. We can do the same thing: and if that happens people can leave, will leave and are leaving. It is disheartening, after encouraging a junior doctor into training, coaching them through the examinations, and celebrating their being qualified, to find tha the management do not have a job for them, or that Townsville or similar has given them an offer that is much better than what is available locally. All specailist qualifications in NZ are binational & I get a letter a month from Australia offering me salary packages about half as much as what I make in NZ>
3. In the end, the science around talking therapies has been established. Firstly, for most anxiety disorders, behavioural or cogntive talking therapies are the treatment of choice. (The correct links to look at are Best Treatments, or the underlying data in Clinical Evidence or the Cochrane Database) For mood disorders, medication, interpersonal therapy (a short form of psychodynamic therapy) or cognitve therapies are the best available treatments. For the psychoses, medication with family therapy or cognitive therapy for psychosis seem to have best evidence…
I find people who criticise doctors for “not acknowledging science” odd. All treatments need to be shown to be safe and effective — we should nof offer unsafe and useless treatment options! Much of the research we quote on talking therapies comes from trials of treatments developed by psychologists, nurses and psychotherapists. Psychwatch has set up a straw man.
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Local patient advocate showed me a printout of the site today.
Some issues.
1. All doctors make some mistakes every year, and we all pray that no one gets hurt. But they happen. We have systems (peer review, audit, double checking of important information) to minimise them.