Query

I used to be quite secure (some might say smug) in my knowledge that I had never faced a College complaint. I prided myself on this. I thought it was representative of the kind of medicine I practised, good medicine, medicine that was above reproach. And when I read or heard about other doctors' alleged malpractice or wrong doing, I — while not exactly going so far as to condemn them as guilty — thought there must have been something wrong with them, something about their practice style, about how they conducted themselves, that left them open to accusation.

Figure. Photo by: Fred Sebastian

Now I've been accused myself, and I'm quickly doing some backpedalling. I think my own situation unfair, that I had only the best of intentions, that the patient bears most of the responsibility for what went wrong, and that I'm just a scapegoat for a bad outcome. Now when I read of other doctors' problems I'm more understanding. I wonder about what's been left unsaid in the decision. I wonder about extenuating circumstances — perhaps the doctor had problems at home or was just having a bad day. I realize many cases are plausible, are situations I could find myself in, and I'm often left pondering whether I'd have done any different under the circumstances.

I have to face it: the likelihood is that a doctor will face a College complaint or require malpractice representation at some point in his/her career. When I tell colleagues of my own trouble, they invariably tell me of theirs. Some have had it happen to them more than once! And these are people I trust, respect and know. They tell me that it's like a rite of passage: you're not really a doctor until you've been put through this particular kind of hell.

It's a far cry from just a year ago, when I thought myself unimpeachable. Now I know I can be sued no matter how hard I try to do good. I can do everything right and reasonable and still face a complaint. And I have to admit, it makes me angry: why should I have to be put under the microscope when I feel I've done nothing wrong, when I feel the fault lies with the patient and not with me? Why doesn't the patient undergo a similar process of examination?

This can quickly, and often, turn into self-pity, where I lament that I try to be the best doctor I can and still get sued.

It's a revolutionary experience. Now my notes are impregnable; I write much more now, for fear of future litigation. At the end of all my notes I write that I advised the patient to go to Emerg if symptoms get worse. I focus more attention on protecting myself from my patients as opposed to helping them.

And always now, at the end of the day, my final thought is, “Is all of this worth it?” When I ask my colleagues how they deal with that thought, they tell me: “Getting a complaint is part of being a doctor. It's part of ensuring a system that protects patients.” In short, they tell me to grow up.

Which I'm doing.

— Dr. Ursus