Feature
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Sham Peer Review request
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Genuine concerns about doctor
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Investigation of the complaint(s)
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Done poorly or not at all
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Investigation done more carefully
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Time pressure
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Putting pressure on doctor to answer the complaint very quickly, without
access to records and within a couple of days e.g. on weekend for complaint
made on Friday. When this is complied with, refers to regulator anyway. Does
not seek clarifications from doctor if not happy with a reply. Poor conflict
management skills.
Pulls doctor out of the clinic while seeing patients for an urgent
meeting to answer a non-urgent complaint because “busy” at other times.
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Given reasonable period to respond
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Hoarding of minor complaints
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Complaints not disclosed to doctor on time but reserved to hit him/her
with several complaints at once.
Habitual stacking of complaints and issues not dealt with.
Pathological avoidance of situations which may give rise to a difference
of opinions.
Pathological fear of conflict.
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Complaint(s) disclosed promptly to doctor to answer
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Abuse of poor policy or
process
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On reading regulator’s faulty policy e.g. policy which has features
of indirect discrimination against a group of doctors (like those who are
contract workers or in private practise) decides to use this to get rapid
access to the regulator
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Not used
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Language of serious concerns
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Complaints written in a way to maximize the interest of the regulator
in the absence of harm to patients: “I have serious concerns about Dr……”
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Evidence of harm to patient or potential harm to public presented
after thorough investigation and when other options are not feasible
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Emotional abuse/humiliations
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Statements as to the mental health of the doctor in the absence of
any medical evidence or reference to the internationally accepted criteria.
No referral to Occupational Health or any reference to doctor’s medical
practitioner.
|
Refer doctor if ill to Occupational Health promptly without referral
to regulator and ensures right questions are asked and answered. Patients
protected by use of locum doctor to cover absence due to illness
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Gain
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Preservation of own reputation takes precedence over lives of others.
Sham peer review serves as a cover up of own wrongdoing
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No gain from making a referral to the regulator
.
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Honesty
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Prepared to lie on oath. Tries to cut a deal so to avoid giving
evidence on oath if written statement is accepted
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No need to make false allegations has evidence to back the complaint
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Staff turnover
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Higher than average staff turnover and a more frequent user of
regulator’s services
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Normal staff turnover
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Culture of bullying
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Over the period of years bullies tend to surround themselves with bullies.
Authoritarian approach, dislike of dissent
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Complaint politely submitted outside the culture of bullying
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Manipulation and status
seeking
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Infiltrate medical establishment as additional means of self-protection.
This may involve the regulators themselves i.e. starts to work for them.
|
Has no need for self-protection from within the regulator
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Outcomes for patients after
dismissal of doctor
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Deterioration in the outcomes for the patients when excellent doctor
is dismissed and not replaced
|
There can be an improvement in the outcomes for the patients when
incompetent doctor is removed even temporarily
|
Chronology of referral
to the regulator
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Referral follows after whistleblowing, or threat to the egos, or fear
that disclosure may occur more widely outside the organization, or due to
business rivalry or dispute, or after a court case taken by the doctor
complained about
|
Referral follows from events related to poor patient care
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Concerns about conduct of the
doctor
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More likely to be concerned about the conduct of the doctor, claims disruption.
Provokes disruptive behaviour by doctor in a variety of ways such as frustration
caused by passive aggressive behaviour of hospital administrator or others
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Concern about patients’ welfare
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Allegations
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False and numerous, gossip, hearsay. Witness Statements that get
withdrawn because witnesses unwilling to give the evidence once the process
is in full swing and about to be heard in public
|
True complaints backed by Witness Statements
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Person who makes false
allegations
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Sham peer review complainer is protected by medical regulator.
Determinations by medical regulator do not give the names of, for example,
medical directors who made false allegations to regulator and initiated the
process of sham peer review. The names of the witnesses who gave evidence for
doctor are published.
|
No backtracking on Witness
Statements or secret allegations or little chats with investigators at the
regulator that accused doctor never hears about
|
Wish to do harm
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Despite all the bad intentions that started the complaint process, at
the disciplinary hearings before the regulator the accusers feign surprise
that things got that far for the accused doctor. “I did not mean it”. Denial
in contrast to the actions taken and the knowledge what the outcomes of those
actions could be.
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Patients are real concern
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Protectionism
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Protects either himself/herself and/or other colleagues he/she thinks
cannot live without-feels compelled to work with them
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Protects patients
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Medical records
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Withholds medical records and even when asked by the regulator sends
only bits of the medical records at the time. Disclosure of one single
medical file can take years. Regulator despite their powers to order
immediate and complete disclosure is complicit with delay.
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Sent promptly to regulator and doctor
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Fraud
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The accusers may be involved in fraud, sometimes widespread.
Prepared to send even completely different patient’s records from the
case complained about to the regulator.
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No evidence of financial or other gain to be made by discrediting the
doctor
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Mobbing
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Engages a crowd of people to act as complainants in order to hide
behind them. Creates impression of widespread concerns to engage the
regulator.
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No need to have numerous witnesses to misconduct
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Concealment of evidence
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Documents missing, denies existence even when one document states
another one is attached to it and staple marks are present.
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No need to conceal the evidence
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A User of others
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Prone to prejudice and could use those considered inferior to write
the complaints so as to avoid personal responsibility. Hides behind others.
Divide and rule.
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Not present
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Phoning around to get more
troops
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Telephones previous employers to get them to complain as well.
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Not present
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Pseudo consultations
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Engages in pseudo consultations to get the “green” light to make the
complaint to the regulator. For example, telephones National Clinical
Assessment Authority for advice but actually trying to find if there are
other complaints there already against the doctor. Calls other employers who
also engage in pseudo consultation with Clinical Assessment Authority
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No hostile dependency on other public bodies to get the support to
report to the regulator.
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Personality type
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Snakes in suits
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Unremarkable, no delight in harming others
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