Friday, 18 February 2011

Sixty eight doctors died while undergoing investigations of their fitness to practice by Dr Helen Bright

Sixty eight doctors died while undergoing General Medical Council investigations of their Fitness to Practice. Is it a political issue? I would say it is.

Medical profession is stressful but even if one is very fit mentally and physically injustice does happen to the best and the healthiest. It is impossible for me to say now and exactly why each doctor died and how many have committed suicide. Suicides are generally thought to be unreported by 30-50%. Each year about 10-12 doctors die during GMC disciplinary process. History gives many examples of condemned taking their own lives. Doctors do it during investigations which can be quite hostile.

The suicide rate in doctors is high. Bullies are not weeded out in medical schools or later on in the professional lives of doctors. Even though doctors pay for their insurance policy, the legal defense provided to doctors is discretionary. Professional indemnity providers shy away from foreigners, and women (not when they take their money). They do not provide much resistance against sexism, or racism, for example.

The investigatory procedures themselves are quite brutal. One cannot reason with the investigators who cover themselves up with faulty medical advice given to them (secretly) by GMC own Medical screeners. They protects medical profession for being shown up to the public in cases where there is ganging up by a group of doctors who target a vulnerable individual (locum, woman, foreign doctor or a depressed doctor). Psychiatric examinations are ordered by regulator when unnecessary (particularly for whistle-blowers) and not when necessary (particularly when the accused doctor is going through a period of religious mania). The regulator covers up for the real offenders and persecutes scapegoats until the very end.

There is a great deal of pride in family, usually, when their member becomes a doctor. Feelings of shame due to disciplinary process could overwhelm some doctors when combined with adversarial approach rather than the truth finding system.

High performance expectations from doctors themselves and others could have an effect on what happens when investigations by regulator commence. For some doctors it is better to die than to suffer humiliations.

Of course, there would be doctors who might have been physically and/or mentally ill without having the awareness of it, or to have avoided the necessary treatments for various reasons. It is a fact that mentally ill people, in general, suffer more attacks including violence than normal population. There are more attacks on them than attacks by the mentally ill on others.

The suicide rates amongst doctors are not the same everywhere in the world. There are also gender differences. While American studies showed no difference between female and male doctors, UK and Swedish research did show that women doctors are at the higher risk of suicide compared to the general population. Sexual harassment of women doctors and discrimination against them do occur and are not addressed properly by the regulator such as GMC which sent twice as many women to psychiatrists during investigations and refused at the same time to deal with the offending doctors who really do cause problems. Even when good evidence is provided for justice to be done nothing happens. The regulator is asleep, unaware that times have changed and that not everyone is equally well adjusted. Misogyny does exist in medical profession. Click here to read about "how slapping a bitch can bring a look of satisfaction".

Sexual discrimination leads to false allegations being made that doctor has performance problems and the requests from GMC for humiliating investigations such as performance assessments, all ordered very much in the public eye. Medical advisers to the regulator are poor quality too. One of GMC's Expert Witnesses claimed that psychiatric examinations are required if enough people say so. What rubbish! It is not the number of people making the allegations of madness but the actual substance of the allegations which require investigating and not dumping on other medics.

Social and political problems encountered in medical practice can lead to unnecessary persecution e.g. by the religious lot who may feel they should have even more special privileges rather than putting patients' interest first as required by GMC own code. In UK, political system does allow religious privileges. There is no screening of the investigators when it comes to their judgmental attitudes and no staff working at the regulators gets disciplined ever when they fail to investigate what they should and investigate what they should not. For example, there is obsession to servicing medical staff offended by what a doctor said and not with the actual deaths of the patients resulting when the same good doctor is dismissed.

Complaints of no merit can completely destroy doctors' lives. Further down the line doctors can encounter rejection from their lawyers too. This can lead to a sense of utter hopelessness and suicide when one is betrayed by everyone who should be helping.

There are also times when good legal appeal advice from barristers is not communicated to the doctors and is hidden by those who are meant to give it to the doctors- their defense bodies. Therefore, doctors may think there is no chance to overcome their difficulties with the regulator when there is every chance to do so.

Occupational health screening for the staff working at the regulators in general, does not exist. Alcoholics can administer justice in a number of different roles at GMC. There is no random drug screening either. Certainly, no screening for sexism or other bias is ever considered. There is no personality tests administered either. Or tests of conformity.

Racial discrimination has been the final straw for many doctors and investigations by the General Medical Council can lead to unemployment and complete financial ruin as the reputation can be damaged beyond repair by mere investigations. Disciplinary investigations have to be reported even if the findings are positive for the doctor. Hospitals ask: Have you ever been the subject of any investigation? What was the result? Why? It can take three days to explain why in some cases. Who wants to hear it? Not a busy medical director.

There are interesting historical perspectives on suicides increasing after and during Revolution (Russia, France).

Dmitri Zhbankov not only noticed that official suicide figures were nothing like the real ones (because newspapers reported them and he collected this information) but he realized what it was about! He actually had the insight that suicides were a political issue, a symptom of the deep-seated political pathology spreading into Russia 1905-1911.

The UK Labour government hid the patients' suicide figures from doctors because at least some of us do know what it is about and we would tell the rest of the world. Now we know that it was about us, doctors too.

1 comment:

Anonymous said...

There should be a fairer disclosure and the Employers and the Regulatory bodies should ask appropriate question such as

- Have you ever been subject to any determination by a Regulatory Bodies during fitness to practice hearing such as having conditions,being suspended etc.

and other questions such as

- Have you ever been subject to any investigation by any Regulatoy Body?

- Have you ever been subject to Fitness to Practice Hearing by any Regulatory Body?

should be scrapped as its open to abuse.