I am a hospital doctor who is thinking about leaving the profession I love. It is not because I doubt my calling, or because I am not competent. I have received many accolades over the course of my career and have an outstanding record of excellent outcomes and high patient satisfaction. But for every 99 cases I take on, one does not go altogether smoothly. It is usually due to events beyond my control, or unforeseen complications. Patients don’t always do as well as expected. Some patients die in hospitals and it is no one’s fault.
But that isn’t how the lawyers see it. These opportunists see the heath service as get rich quick scheme and doctors like me are collateral damage. I know it’s not personal for them. They see it as an adversarial game. But I am a doctor who has dedicated my life to caring and I take it very personally indeed. So do many of my colleagues who are battling legal suits rather than concentrating on improving their medical skills and looking after their patients.
You can find these lawyers outside hospitals, putting their cards in the A&E departments and swarming through the coroner’s courts. These courts, which used to be places where relatives could hear the experts describe the details that lead to an unexpected or unexplained death, are now testing grounds for damages claims. It doesn’t help that the number of cases going through coroners court is rising exponentially and the justification may be as little as the fact that a patient died in an ICU. This is a massive extra burden for doctors, particularly those working in intensive care, since they find themselves having to give evidence so regularly that they are now given sessional time each week to attend the hearings. In the past, an NHS doctor might have expected to attend a coroner’s court once or twice in their entire career.
Don’t underestimate how stressful and difficult this burden has become for doctors like me. I find myself regularly having to justify my actions and defend my professionalism in an increasingly judgemental and hostile environment. The coroner is not the problem. It is the lawyers who represent the deceased who challenge minutiae in an attempt to find fault and presumably start the gravy train of future litigation for damages. The lawyers have made life for doctors increasingly difficult over the years but patients, and their next of kin, have adopted unrealistic expectations that anything less than perfection means someone is to blame.
In my experience, it isn’t necessarily the sad cases where something does go wrong where lawyers get involved within milliseconds of the discharge papers being signed. Rather, it is cases where doctors performed heroically to try and restore someone to life who arrived on the brink of death. Or when an elderly person with multiple chronic conditions expires because one of their comorbidities has not been the focus on attention. Surviving relatives increasingly find it difficult to accept that their loved ones are simply mortal. If we don’t perform like miracle workers, we deserve recriminations and punishments. Of course, these people are often engulfed in feeling including guilt and grief. Lashing out at others could be said to be a normal reaction to loss. But when a lawyer can seize on these emotions and turn them into weapons against hard working doctors and nurses trying to do their best, the whole system disintegrates into expensive and damaging acrimony and finger pointing.
And the bodies that are meant to represent doctors and support have become our tormentors. We pay for the GMC to regulate and oversee us and protect our good name. What has happened is that this organisation, which we fund, has adopted an aggressive stance against the very doctors it is meant to support. Guilt is assumed until innocence can be proven. I have witnessed high performing individuals who have been placed under the scrutiny of the GMC reduced to skeletal wrecks over the course of investigations that can last years. Yes, they are finally exonerated but not before they have given up much of their practice through the debilitating stress they have experienced. It doesn’t surprise me to learn that doctors under investigation by the regulator face a suicide risk 13 times higher than the general UK population.
If the government really wants to boost the morale of its NHS staff, it needs to step in and protect us – for the sake of patients and clinicians alike.