How to Survive a Complaint from Another Clinician

[00:00:00] Rachel: if you’ve had a long career in healthcare, chances are that you’ve received a complaint. It could be about the way you spoke to a patient, a mistake, or simply misunderstanding about the treatment that you provided. And it’s never been easier for people to complain, whether it’s through a simple online form or just taking to social media. But a professional complaint from a colleague can land very differently and hurt us more deeply.

[00:00:23] Rachel: This week I’m joined by Dr. George Wright, legal consultant and Deputy Dental Director of Dental Protection. Now, George had a complaint made against him earlier in his career, which he believes led him to the work he does now, helping other healthcare professionals navigate the complaints process.

[00:00:37] Rachel: One of the things we discuss is the often unintended escalation that so-called blue on blue complaints may trigger even if the person wants to withdraw the complaint later. This often leads to long and drawn out proceedings on both sides, and often no resolution for either party. So we talk about what to do instead of going straight for the nuclear option and also when the nuclear option is necessary.

[00:01:00] Rachel: And if you’ve experienced anything like this or you’d like to know what to do, should a complaint land on your desk, this in-depth conversation with George will give you the resources you need to take the right next step.

[00:01:13] Rachel: If you’re in a high stress, high stakes, still blank medicine, and you’re feeling stressed or overwhelmed, burning out or getting out are not your only options. I’m Dr. Rachel Morris, and welcome to You Are Not a Frog.

[00:01:31] George: My name’s George Wright. I’m a general dentist by background. I now work full-time for Dental protection, Which is part of the Medical Protection Society as a dental legal consultant and deputy Dental Director.

[00:01:44] Rachel: is great to have you on the podcast, George. Thank you so much for coming on. and I think this conversation’s going to be really interesting because the one thing that I know doctors, dentists, nurses, healthcare professionals, fear above all things is complaints. And this fear of complaints drive so much of our behavior, uh, whether it’s, you know, avoiding saying no, because we don’t want to upset anybody, or just over investigating because we don’t wanna get things wrong, or just doing stuff that we probably wouldn’t normally do but just because we are so worried that, that the patient is upset or maybe one of our colleagues is, is, is watching over our shoulder. And so we end up making these decisions out of fear rather than out of our deep intuition, knowing that that’s the best thing to do. So obviously you are a complete expert in this area.

[00:02:32] Rachel: Um, just very quickly, what sort of complaints are you seeing at the moment in general?

[00:02:38] George: Well, yes, there has been a, a change in trends. Uh, we’ve had COVID, which of course is, was, you know, a complete anomaly in itself, but in more recent times, the real driver, I think, and the, the thing that’s really changed up the way patients approach their healthcare is social media.

[00:02:55] George: So with social media comes a real change in patient expectations. Patients are more aware of what they are, let’s say, entitled to. They’re more aware of what can be achieved and what can be delivered. Um, and they’re also, uh, more aware of what tools they have at their disposal when things go wrong, be that complaints to clinicians directly or, you know, using social media itself as a, a tool to, uh, criticize their clinician.

[00:03:25] Rachel: It’s a whole new ball game, isn’t it? And misinformation that’s out there is really scary as well. So I, I asked one of my children the other day, where’d you get your information from? Oh, TikTok, she said. I said, okay, so how do you know if that information is true or not on TikTok, or right? And she said, oh, look at the number of likes it has. Oh no. I said, okay, but what, what else? She said, well, I look at who’s commented, and like, if it’s somebody famous, everyone knows it’s commented. That’s like, right, that, that it’s right then that’s probably okay. And I was just like, oh my goodness.

[00:03:56] Rachel: So we are no longer believing experts are we? We, we are believing popular people. People that are famous people have got big followings. Oh my goodness.

[00:04:04] George: Yeah. No, that, uh, I mean, that’s really interesting perspective. I suppose the answer is get a celebrity patient into, uh, boost your exposure. But that, you know, I, I think you’re right. I think, um, misinformation is a problem. Where we see that in dentistry in particular is things, uh, like, just to give you an example, before and after clinical photographs.

[00:04:22] George: So a clinician can put some photographs on their Instagram, for instance, and, you know, you have no way of knowing whether those are credible photos of, of treatment that dentist has performed and completed. Um, and indeed you have no way of knowing what sits behind the photograph. Was that patient actually hap happy with the treatment? Was the dentist a good communicator? Did they deliver on what the patient was expecting outta the treatment? None of that is delivered through a, you know. short Instagram posting, is it?

[00:04:51] Rachel: No, and that leads me onto my, the thing I’d like to talk about is complaints, um, doctor on Doctor or dentist On dentist or, you know, in interprofessional, because, you know, we’ve talked a bit on this podcast before in Association of Medical Protection Society, and we’ll, we’ll put the links in the show notes about how to deal with failure, manage yourself through complaints and things like that.

[00:05:13] Rachel: But what about when it’s one of your colleagues complaining about you? And I can imagine that when you see in social media some misinformation being spread by some quite prominent characters who, identify as doctors or as dentists or my pet bug bear is nutritionists.

[00:05:30] Rachel: There are some absolutely fantastic, very good nutritionists out there. Big shout out to, uh, the, the, the Doctor’s Kitchen ’cause they are brilliant and a, a, a GP that runs that really good stuff. But there’s some stuff out there that is just completely wrong and making people spend so much money on stuff that’s not gonna help or might even be dangerous. And when you see that you think someone’s got to do something about this, they need to be reported to the GMC for, for putting that on, on on Instagram, you know, but that’s not always helpful, is it?

[00:06:01] Rachel: But I think that is a reaction when we as healthcare professionals see another healthcare professional doing something we think is wrong. And the problem is that can be really, really destructive, can’t it? I mean, there’s that macro level of you don’t know them at all, they’re on social media, they’re a prominent figure. But then there’s that micro level of, of people you might even be working with.

[00:06:21] George: Yeah, and I think, I think to the point we’ve just been talking about in, in regards to social media, perhaps not actually representing things, the same is true with the, impression that one clinician might gain of another. It, it’s a very, uh, narrow insight into what’s going on, and there’s always a story that sits behind what might be causing you concern.

[00:06:42] George: I think you’re right. I think, you know, what we, we would say is blue on blue, you know, is, is the term used for these so-called clinicians complaining about other clinicians and they’ve, they’ve absolutely got their place. Don’t get me wrong. You know, if, if you see something taking place that’s putting patient care at risk, of course you have a, an ethical and a professional responsibility to raise those concerns.

[00:07:03] George: It doesn’t always have to be the case that you have to reach for the nuclear option and refer them to the regulator. it’s important I think, to look behind what your motivation is for making that report and whether indeed the, the mechanism that you have in mind is the most appropriate mechanism or whether there might be something more suited.

[00:07:23] Rachel: because. Why is it that most of us, most, I say most of us, I’ve never done this, but a, a lot of blue on blue complaints are directly to the regulator. They’re directly already at the escalation stage, rather than starting from the, the bottom of the escalation pyramid, which is something I’d like to ask you about in a bit.

[00:07:41] George: Yeah, I think, I think that’s a really good question. I think there’s probably two reasons. I think one is a misunderstanding of the mechanisms that are available, so using that escalation process, making sure that you are pitching your complaint or concern at the right level to get it dealt with effectively but proportionately.

[00:07:59] George: And I think the other reason, and this is perhaps more cynically, uh, pitched, is that if an individual has themselves been in the recipient of a complaint to the regulator, particularly by another professional, then emotionally, I think often the response is to retaliate with a similar complaint to the same regulator.

[00:08:22] George: And so I think it’s really important to really, I suppose, look inwards before you make any reports, any complaints, really scrutinize your own motivations for doing that, and take advice so you can understand whether indeed that is the most appropriate course of action to get the outcome that you are looking for.

[00:08:43] Rachel: so much in that, isn’t there? So I think first of all, yes, it’s a motivation. Like why is it that I’m making this, making this complaint? Is it to correct stuff that’s factually wrong? In which case, yeah, why would you go to the GMC? Why wouldn’t you just message them?

[00:08:57] Rachel: And I know, you know, when we put stuff out on Instagram about burnout and stress and resilience, um, if we ever get any pushback from people or complaints or, or people right to us, occasionally we do get some feedback about stuff, I take it really seriously and I, I always change things and I always look at what we’re doing and thinking is, is that, is that right or not?

[00:09:16] Rachel: So I think people maybe assume that their feedback isn’t going to be listened to. I think that firstly, most feedback is really listened to and it’s really, really valuable. So there is that, that that motivation about is it, ’cause I want to correct stuff out there.

[00:09:31] Rachel: I guess when it comes to the social media type stuff, there might be a bit of jealousy on people’s, you know, if there’s a very, very prominent doctor or psychologist in the, in the media, people just wanna have a pop at them, don’t they? And, you know, I do think that happens a bit as well.

[00:09:46] George: I, I think that’s absolutely right. So I, um, I’m, I’m joining you today actually, as it happens from Hong Kong. NPS has a me, uh, a, a presence all around the world, and, uh, one of our significant jurisdictions is Hong Kong. And so I, I’m over here at the moment listening to colleagues talk to me around the challenges that they face in their own professional lives.

[00:10:06] George: ‘ Cause Hong Kong is, so if I just give it as an example, because I think it is relevant to the UK and beyond, it’s, it’s such densely populated area that the competition is so high. You know, you can have a dental practice on, you know, floor 30 of a building a dental practice on floor 32 and another one on floor 34. So it’s so easy for patients to walk and move between one practice and another. So there is that real competitive spirit between the practices.

[00:10:35] George: So using that mechanism of complaints, be it in relation to social media, be it in relation to advertising, which we see particularly over here where it’s really heavily regulated, it is very often used unfortunately as a mechanism for that, I suppose, competition for space in the market.

[00:10:52] George: And if you transfer that across to the uk, it’s, it’s definitely the case, probably not as, um. Concentrated, but we do see complaints from clinicians, uh, arising from the practice down the road. You know, it’s, it’s very rare that you get complaints from somebody that is remote from your own practice. Invariably, it’s linked in some way to proximity and therefore, uh, competition for patients.

[00:11:19] Rachel: I have definitely seen it in, uh, hospitals, apartments where there’s been some private practice going on and there’s a new kid on the block and they don’t like, there’s a sort of consortium of consultants that don’t like this new kid on the block, and invariably within the first couple of years, a GMC referral will be made by one of the other consultants in the department. I’ve seen that happen quite a few times. it’s really despicable behavior.

[00:11:43] George: It, it is. And, and generally speaking, the regulators don’t like to be the battleground for these interprofessional disputes. I mean, as I said at the outset, it’s absolutely right that some complaints are referred to the regulator, but I think sometimes the challenge lies in how easily done it is.

[00:12:01] George: You know, you can report someone now in the space of five minutes on an online web form. You press the submit button, you shut the lid of your laptop, or you lock the screen on your phone and you carry on with your day. But what you have just initiated in the, in doing that is a significant process that’s going have a huge emotional turmoil on the recipient and incidentally can’t be stopped. Once you start that process going particularly so far as the GDC is concerned, they will investigate it. You cannot wake up the next morning and think, actually, perhaps I was a bit hotheaded in sending that off. Perhaps the appropriate thing might have been to have a chat to this individual and ask the GDC if you can withdraw the complaint. The GDC will say, investigation’s been opened and we need to look into this now.

[00:12:52] Rachel: that’s really quite sobering. And it is often very long process, isn’t it? Isn’t it? Can I just ask you very quickly, how quickly will they throw out okay, if it’s obviously vexatious or malicious or malignant, you know, does it still take them a year to sort it out or can they like look at that pretty quickly and go, actually there’s, there’s absolutely no grounds for investigating here.

[00:13:11] George: Well, there’s two answers to that. First of all, if I can, let me just indulge you with, um, my personal experience. So I was reported to the GDC, uh, 10 years ago, and admittedly the GDC is, has improved considerably in that time, and I’m not suggesting it would be the same time scales today, but in that situation, which related to a single patient that I had seen on one occasion for an emergency appointment. It took nine months for the GDC to write to me and tell me that I’d done nothing wrong and they were closing their case.

[00:13:44] George: And that was nine months at a very, you know, difficult time. I’d I, you know, relatively new into the profession. Um, you know, had just bought my new first house, got a mortgage, um, you know, starting to make financial commitments. And then ultimately you are, you are, you are facing a process that could lead to your avasia from the register and the end of your career. So that’s, um, you know, you can’t underestimate or understate that.

[00:14:08] George: There has been progress made. Um, you know, it’d be unfair of me to suggest otherwise, but we are still looking at cases that take a number of months, even the most straightforward cases to be closed at that initial triage stage. And if you are unfortunate enough to be in this, in the situation of a complaint. It goes all the, through the process to a hearing, well, hearings are now being scheduled well into 2026, 2027, so you are looking at years. If you were to get a complaint today that went to a hearing, you’d be looking at years, months, certainly not weeks or days for that to be resolved.

[00:14:46] Rachel: And that takes so much of an emotional toil, doesn’t it? We’ll, we’ll talk about that in a minute. But I guess one of the questions you’d ask us yet, would you inflict that on anybody? Like even if it’s someone that you know, you don’t like particularly, that, that toil and, you know, doctors, you know, speaking from my own experience of, of, um, luckily I’ve never been referred to the GMC. I’ve had complaints, but I I, I was never referred to the GMC, but I had colleagues that were, and yeah, it took two or three years and they were all exonerated.

[00:15:17] Rachel: And, and even if you actually know in your head, you are very unlikely to be struck off. And the, the recent, um, numbers that I’ve heard from, you know, certainly amongst doctors, medical doctors refer to the GMC, is that most people don’t end up in the Fitness to Practice committee unless they’ve been really bad, you know, unless they’ve done something criminal or they’ve shown absolutely no insights.

[00:15:38] Rachel: And, and actually the reality is. You can make mistakes. Yeah. We all make mistakes. We know we do. And if you have some insight and you show you’ve learned and all that sort of stuff, you’re very, very unlikely to be struck off. So in our heads, we know, you know, in your head you knew there was probably a zero chance of you being struck off a lot or, you know, might be suspended for a couple of months maybe, maybe. But actually you’re not gonna, you’re not gonna lose it.

[00:16:00] Rachel: But it is such an emotionally difficult process and it’s there in the back of my mind all the time. You know, there must be other reasons, not just am I gonna be struck up, off or not? For that process to be so prominent. And of course so many issues for doctors and dentists and other healthcare professionals that are going through it.

[00:16:19] George: I mean, you’re, you’re absolutely spot on. Of course you are. And, and I think, you know, first of all, I think you are right to say that the vast majority of cases will be closed without the ultimate sanction of erasure. It is a really tiny, tiny percentage. And when you look at the cases that lead to erasure, it is right that those individuals are removed from the register, okay? It’s, it’s right for the profession, it’s right for the public. We not talking you. Isolated clinical areas, we’re talking criminality and, and such serious matters.

[00:16:49] George: But you, you do go on that emotional journey. You wake up every morning, you go to work and you have a coffee with someone in the cold light today, and you, you kind of see things with really good perspective and you think, no, this is gonna come to nothing. But by the time midnight comes along and you’ve been sitting tossing and turning for three hours, you can very quickly catastrophize yourself up to, yeah, I’m gonna be erase from the register and this is the end of my career.

[00:17:13] George: So, yeah. I I, I think it’s so important to keep that in mind when you make a complaint. And I, you know, I, I I do want to emphasize that I’m not putting the point here that you shouldn’t escalate things to the GDC. Absolutely right. You know, there are cases where indeed you have a professional responsibility into not raise es and escalate concerns, you would be putting your own registration at risk.

[00:17:39] George: But if the matter can be effectively dealt with at a more local level, then that is in everyone’s best interest, uh, not least the person that would be the recipient of the complaint.

[00:17:52] Rachel: Do you think people just go straight to the regulator? Because it’s the easy way to do it? It’s the easy way out, and to me it just seems like the coward’s way out

[00:18:00] George: Yeah, I, I think certainly the easy way. Um, certainly, you know, it, it, it takes a lot of resource to investigate a complaint properly, particularly those that have multiple patients involved or systems and process matters to be considered. it is helpful to have the GDC there for those, I think cynically looking at it to, uh, kind of take that burden on themselves and, and have the resource to investigate it. Um, I do however, think that a lot of the motivation is a lack of understanding, that actually you don’t have to go to the ultimate arbiter.

[00:18:36] George: Let’s give an example. You see a patient and you are, uh, a little concerned about the approach that the other dentist has taken. Okay? It might not be, uh, totally unprofessional, just, you know, you think actually not quite how I think this should have been done. That’s not the remit of the GDC. The GDC is there to deal with those individuals who, you know, if the allegations are found, prove would not be fit to practice. They, they should not be the dentist, be a dentist. That’s ultimately what you are saying. And it’s got to be better for patients. It’s got to be better for the profession, for those types of complaints to be dealt with an investigated at a local level, whether that’s within the hospital trust department or whether that’s within a particular dental practice.

[00:19:18] George: Uh, and, and I think there’s two ways to support that. One is training. So having an effective training process so that everyone in the practice is aware of both their obligations, but also the mechanisms for escalating concerns. But also the need to ensure that you have a really visible process and you have somebody that takes ultimate responsibility for complaints handling or dealing with interprofessional concerns within any, any setting.

[00:19:48] George: And if you have that, then anybody with a concern, should have confidence in that process such that they don’t feel the drive to go to the regulator to deal with their concerns.

[00:20:01] Rachel: Yeah. The problem with that though, George, is that I hear, uh, there’s a local expression, it’s probably a national expression, secondary care doctors. Oh, yeah, I Datixed him, I Datixed them, and I think Datix is the reporting system, so it seems like, yes, the hospital thought, right, we need to make this way of reporting errors. They probably, I’m, I’m hoping it was from good motivation. They probably read the Amy Edmondson stuff about the, you know, the, the good organization reports the mistakes and errors so that they can learn from them and all that, but that just seems to be weaponized. So you Datix someone or you just, I ignore it totally because it’s, it, it’s too difficult to say anything and you think it’s easier not to.

[00:20:40] Rachel: So I think even when there are structures in place to deal with things locally, they either get weaponized or they get ignored. And so you keep putting these Datixes in and nothing seems to ever be done. Nothing’s fed back to you. So then you lose confidence in the process.

[00:20:56] George: Yeah, I think that’s really fair challenge on both co, on both counts. So, uh, you know, in in general dental practice, there are certainly, you know, you, you will have individual processes. We wouldn’t have Datix process, but you are right, certainly in hospital trusts, Datix, uh, you know, it, it’s definitely got its positive points because it allows individuals to raise concerns without having to have necessarily difficult con conversations. And, and let’s face it, not everyone is comfortable having those kind of discussions.

[00:21:26] George: And okay, yes, it’s still being weaponized. I, I concede that point, but if I was going to be a, you know, on the receiving end of a weaponized process, I’d much rather have to have a difficult conversation with a hospital manager following a Datix report than I would to be having to go through an investigation with the GDC or GMC.

[00:21:46] George: And I think, you know, we have to take a pragmatic approach here. There has to be a process in place. There has to be a system in place, and unfortunately, I think it’s gonna be, uh, really difficult to get to the place where you have a system that is totally free of being weaponized.

[00:22:04] George: I, I should also say, Rachel, I think it’s important to, to make the point that yes, these things do get weaponized, but we are talking, you know, relatively low numbers, okay? So the GDC clinician on clinician complaints account for less than 10% of concerns that land on the GDC’s desk. And by and large, clinicians are very good, very capable and competent, confident to have those difficult discussions.

[00:22:32] George: You know, I will very often receive phone calls into dental protection from colleagues who say, actually I’m concerned about my colleague, i’m gonna go knock on their surgery door at lunchtime, I want to have a chat with them. Have you got any pointers for how to open that discussion. So you know it happening? I think we can and should do better. And I think really that needs to be the, the direction forward.

[00:22:55] Rachel: If you, and I think that’s really good and what’s really heartening is that actually people can phone you up and go, what should I do about this? And that, is that something that the, you know, medical protections enter protection would really invite people to do.

[00:23:08] George: Absolutely. I think in any situation where you have concerns about another professional, we would always be happy to have that conversation. Now, what you are not going to get out of me, and, and I suspect my colleagues as well, is an answer of, yes, you need to, or no, you don’t need to report them to the regulator. We we’re not there to take away that decision making burden, which unfortunately has to sit with the individual that is closer to the situation.

[00:23:34] George: But what we can say is, have you tried. Discuss individual. Have you explored what mechanisms are in place in the organization you are working? And if you are having a conversation with us in which you’re saying, look, there are, you know, serious concerns here that are repeating, that are not being resolved despite me following all those processes, then it may be that we say to you, well, look, you have a professional responsibility and you need to be mindful of that. And perhaps it’s appropriate for you now to give consideration to, um, what are the mechanisms of escalation you have at your disposal.

[00:24:11] Rachel: it is always useful to sense check stuff with a a neutral party. I was just thinking would you go to a colleague and talk about it first before you came to sort of your, your medical, protection society?

[00:24:23] Rachel: But actually I’m thinking some, sometimes your, your colleague is sort of as invested as you are or as sort of can be, can feel a bit aggrieved as well or whatever. And so actually getting a very neutral perspective I think would be helpful.

[00:24:36] George: Sometimes being too close to it, knowing the personalities, and, and all the negative connotations that can come with, with that perspective. But also, perhaps a better example is, you know, we get so often now, colleagues will go to forums for advice. So they’ll, they’ll ask on Facebook.

[00:24:54] George: There’s a very famous Facebook group with tens of thousands of dentists on. Now, if you seek advice there, you’ll get the whole range of answers, and you’ll be given answers from someone who, again, can type a response and shut the lid of the laptop and they’ve got no interest in the repercussions. So if they say, yeah, you need to go to the GDC, then it’s very easy to write those few words, isn’t it? But then you are the one that then has to make those difficult decisions ultimately, and you get drawn into that process.

[00:25:24] George: So yeah, it, it, it’s an absolute difficult balancing act and I think the objectivity which dental protection or medical protection can provide, particularly because our advice is in the best interest of the person ringing us up, um, can be invaluable in those situations.

[00:25:41] Rachel: Yeah, I’ve certainly seen there’s a very large, um, physician’s Facebook group and yeah, someone will say, can I have advice about this? This is what happened. And people are going Report, report, report, that’s awful, that’s awful. And you’re thinking, well, yeah, if you put it like that, it sounds awful, but there’s gonna be, there’s going to be context around that.

[00:25:57] Rachel: And I, you know, I know in our own organization, you know, we’re not seeing patients anymore, but when something has been done wrong or something happened, I, I used to react like, and go, well, this, this, this was wrong, this needs to be, this needs to be sorted out. Now the first thing I say is, oh, what happened here? Let’s hear what happened. And The explanation always makes me feel far less serious than it, than it felt.

[00:26:18] Rachel: So I really try and say, it’s like, oh, I’ve noticed this. What happened? They’re like, oh my word, I’m so sorry. And often that’s exactly what you want. You just want somebody to be aware of what happened and a, and an explanation of why it happened and to know it’s not going to happen again.

[00:26:34] Rachel: And that is done much, much better with a initial conversation. But what I think people have trouble doing, it’s raising it in the first place..

[00:26:42] George: It is. You are right. You are right. I think two reasons. One, it’s, it’s just uncomfortable, right? And sometimes the person you are speaking to, you will know them and, and they may be a, you know, difficult character, you might anticipate some challenges that with that conversation. And also I think clinicians are always mindful of what repercussions it might have on them. Um, particularly when it comes to these so-called blue on blue complaints.

[00:27:09] George: The fact that it is not uncommon, unfortunately for somebody that complaints about one clinician to be the recipient of a, a similar complaint in the other direction. And so I do think those challenges do muddy the water a bit and why getting objective support and advice could be so valuable.

[00:27:28] George: I think just to your point there, Rachel, around context being key just to kind of. add some illustration to that. I deal with cases, uh, across Asia, the UK, Caribbean and I, I have a very set process for how I, how I look at them. I would always start with the patient’s complaints. And I’ll get to the end of the patient’s complaint and I’ll think, goodness me, this is awful. The patient’s been really badly treated here. And then I’ll read the, the dentist or the dental professional’s comments and all of a sudden, the mist clears and you think, ah, actually there was a reason why they did that, or, okay, there’s some context here that actually changes my perception.

[00:28:09] George: If I could put it like this, that I think a lot of complaints raised by colleagues against another colleague are often given li very little thought and often very hotheaded in the way they’re, they’re sent off. And it is back to the point I was saying about how easy it is to raise a complaint on the gd, uh, GDC website. And my advice is really simple to any anybody that’s thinking of raising concerns, it is extremely rare that you will come across an issue that has to be raised there and then.

[00:28:40] George: Very often the vast majority of cases can wait for 24 hours with zero impact. And so drafting an email and letting that email sit in your drafts rather than clicking the Send button and then going to bed and sleeping on it and coming to it with a fresh, you know, pair of eyes the following morning, can be invaluable.

[00:29:02] George: And the number of times I have in my professional life written an email, and by the way, you feel a lot better just for writing it. It’s not the sending necessarily, and then just sitting it, you know, letting it sit there, come to it the next day. And I would say, you know, more than 50% of occasions, I then press the Delete button and I think better of it. And I, you know, have a bit more perspective and I’ve calmed down a little.

[00:29:24] George: So, you know, as you know, a very simple bit of advice from me would be, yeah, if you, if you want to raise concerns about a colleague and you’re not sure how to do it, put your thoughts in writing. Don’t press the Send button and then review it the next day and see how you feel.

[00:29:37] Rachel: The power of the pause, right? When you’re in that sympathetic zone, you’re amygdala’s going Oh, you gotta do something here. That’s the time when you absolutely shouldn’t do it. Yeah, absolutely. The amount of emails I haven’t sent, and I’ve been so pleased.

[00:29:49] Rachel: So then you wait 24 hours and you think, well actually, you know, I do need to either send the email or have a conversation. I, I’m thinking a conversation would be far better than an email, if possible. Is that right?

[00:30:00] George: I think it’s because I think, um, a lot of tone gets lost in email and communication is only small parts, what we say, and a large part of body posture, gestures, facial expressions. And I think, you know, when you are communicating something like that, having those additional cues to support the communication are so important.

[00:30:23] George: But having said that. If you then do not feel that your concerns have been properly listened to or acted upon, then having it in writing is really helpful, because if you are later criticized for not dealing with it appropriately, having that record, that audit trail of what you said, uh, is, is is also of great importance.

[00:30:45] George: And the way I would advise kind of ticking both of those boxes is it doesn’t hurt to have the conversation and then to just gently say at the end of the conversation, so, perhaps it’d be easy for both of us, you know, to help both of us out. If I just summarize what we’ve agreed and I’ll pop it in an email to you. Um, it’s a nice way of kind of tying someone’s hands to an action, but also providing that audit trail.

[00:31:07] Rachel: Would you advise giving them a bit of a warning shot, like saying in an email, um, can I pop over? I’ve got just some concerns about this patient, or someone came to see me and I just wanna understand a bit more, or would you just leave that til you see them?

[00:31:22] George: That’s a really good question. Now, my personal view, I hate emails that say, can I have a word?

[00:31:28] Rachel: Yeah. You worry

[00:31:29] George: you just think, oh, what is it? Yeah. So I, my personal, if I’m the recipient, I would just rather you rip the plaster off, walk in my room and say, I need to talk to you about this and this. I think if you are gonna give someone a, a warning, a advance notice in an email, because that can be helpful. It can give, you know, if you wanna to talk about something specific.

[00:31:48] George: So let’s say you wanna talk about a particular patient, I think absolutely can be helpful to give them the notice so they can go and review those records. They can remind themselves of the patient and you can have a more constructive discussion. Because otherwise what you are gonna get when you knock on their door is, look, I can’t remember the detail, give me some time to read the records. And you’re just kicking the can down the road when you’ve gone to that room, having built up the courage to have that difficult conversation.

[00:32:14] George: But what I would say, just, just to be kinder is give enough information in the email. You know, you, you can say, look, I’ve saw, I saw Mr. Smith this morning, had some concerns around his appointment with you last Tuesday. Have you got some time later on today to discuss it? So there’s no, there’s none of that kind of cloak and daggers, you know, I want to have a word about something serious and you don’t tell them what it is. I just, I juts think it’s, uh, my personal view is. It’s just a kind way of dealing with people.

[00:32:40] Rachel: It’s interesting though, I think people avoid having these conversations, and you’ve already mentioned that when you, when you’re talking to another colleague going, oh, you know, how should we feed this back? Oh no, they’ll take it really badly or whatever. Well, we often really assume that that person is gonna be defensive, they’re gonna take it badly, they’ll be a real arsehole when, when we feed back to them. But, uh, my colleague Sarah always quotes that we overestimate the negative impact of having a conversation and we underestimate the negative impact of not having that conversation.

[00:33:10] George: I think that’s absolutely right and I think, you know, clinicians in general are really invested in their own abilities and their own performance, and they are keen to know when they are, you know, not doing something.

[00:33:23] George: Now, a lot of this conversation has naturally kind of drawn towards the, the sinister motive side. You know, we’ve got someone, you know, some really bad and we’ve gotta have a really difficult conversation. But actually, if it is something, let, let me think of an example. Let’s say receptionists has noticed that all the patients coming out of, uh, my surgery are saying that they feel like I didn’t take the time to welcome them into the surgery.

[00:33:51] George: Now, to somebody that might be a difficult conversation to go and speak. ’cause I might be quite a bullish character, I might be quite dismissive. But equally, I might be totally oblivious to this. And if somebody says to me, actually, George, you, we’ve had a couple of patients that just happened to mention that they quite like the way that the previous dentist, uh, used to welcome into the surgery and offer, you know, to take their coat or I, I dunno, ask them how their day’s going or how their holiday was or something. And that might give me the opportunity to say, oh, yeah, no, I hadn’t thought of that. I, my my impression was that patients want to be in and out as quickly as possible, and that’s why I’m rushing. It’s not because I’m rushing, it’s because I think that’s what the patient wants. I’m really pleased you brought this to my attention and I’ll do that in future.

[00:34:33] George: So it’s, it’s probably not the best example, but you, you know, it, I think it’s fair to say that, you know, the vast majority of clinicians are insightful, are keen to develop and would prefer to have these kind of blind spots brought to their attention.

[00:34:45] Rachel: Yeah. And I always think that feedback. It’s a total gift and we don’t get enough feedback. And this is one of my real bug bears at the moment.

[00:34:58] Rachel: Um, we teach a model of difficult conversation having framework for difficult conversations called the High Five model. And the High in the High Five model stands for highest intent. And you were talking about the fact that, you know, we have been assuming a, a a lot of the conversations we’ve had that you know, that the person’s bad or they’ve got some malicious, either intent by complaining or the doctor or dentist being complained about is lazy or, or something like that. And that is just hardly ever the case, isn’t it? You know, there are some bad eggs in the basket, but mostly people are overwhelmed, they’re stressed, they’re, you know, struggling with work.

[00:35:33] Rachel: And we had, um, Dr. Chris Turner on the podcast recently talking about, you know, what to do when you are the difficult person. And he said he does a lot of appraisals. He’s the founder of Civility Saves Lives movement. Does a lot of appraisals. And he sort of gets given the people that are, have been complained about or, or, or seem to be difficult characters or, or lazy people have thought they’re lazier, not really doing their job properly. And he said, you know, in all his time of seeing these people that not one of them is lazy. It’s other, there’s other factors at work. They’re getting to be burnt out. There’s just too much going on, there’s difficult interpersonal relationships, all that.

[00:36:07] Rachel: And so most of us go to work to do a good job, don’t we? And most of us, when we are raising complaints about other people or notice that something wrong are doing it because genuinely we are worried and concerned about the treatment that patients have had. So if both of you think about your highest intents in that conversation, so why am I having this conversation if it is vexatious and malicious ’cause their, their competition for me in my practice, well, a, I won’t be thinking about what highest intent anyway, i’ll just be doing despicable things. So let’s exclude that Lot of people.

[00:36:40] Rachel: They’ll be thinking, well, what do I want out this conversation? I just want some feedback so they don’t do it again. Or feedback so that they’re aware or just understand more, then that has got to be quite a good way of, of going into the conversation.

[00:36:53] Rachel: And, and even would you advise stating it? So just saying that I just wanted to, to check something out. ’cause something, something happened, I’ve noticed something and I was just a bit worried. I just want to flag it up in case you hadn’t seen it and just check in with you about what was going on and just understand what happened? just so that I’m clear that we are both working to the best of our ability or, or something like that.

[00:37:13] George: Yeah. And what I would say is that I think these so-called difficult conversations, and they, and they are, I’m, I’m not, I’m not minimizing that, but. It does get easier. And I think the more that you have those difficult discussions with your colleagues, the more it will become almost a, a casual, you know, chat over the water cooler. So it, it’s, it becomes, uh, for both parties, uh, a conversation of much less significance.

[00:37:43] George: I don’t mean by that, that it gets dealt with any less, uh, seriously, it is just that it’s in the rear view mirror of both parties a lot quicker and you’re not dwelling on it for the rest of the day. Did I say the right thing? How’s it been received or the recipient’s thinking you know, I feel totally outraged that they’ve come to me with this.

[00:38:03] George: And I think what can really help that is it’s, it’s part of a broader culture piece and that involves offering the positive as well as the negative feedback, and I think that is something that in clinical dental practice, we are particularly poor at.

[00:38:22] George: If a patient goes to see someone and let’s say that the usual dentist is on holiday and they say, uh, you know, I normally see George, and by the way, George is lovely, you know, he was, he always puts me at ease. I’ve always struggled with going to the dentist, but I finally found someone I feel comfortable with. Then I would say, make a note of that really quickly. And then when George gets back from holiday, go and knock on his door and say, have we got two minutes? I saw Mrs. Smith last week. She said You were lovely. Um, she said, you’ve really put her at ease and you know, she feels much more comfortable coming to the dentist now.

[00:38:57] George: And you’ll make that person’s day. You will feel better for it. And it then means that when you need to go and have the difficult conversation, you’ve got a much better relationship of, uh, exchange of feedback with them. Because, you know, in a sense, positive feedback is, uh, also a difficult conversation because you are still having to use all of those communication tools, um, learn to go and interact with your peers, sometimes senior colleagues. Uh, so I think it’s all good in terms of building up that skill base.

[00:39:24] Rachel: Yeah, and sometimes we don’t have those positive conversations ’cause it feels awkward. You are right. They are still challenging conversations. Like, oh, does it feel a bit icky to tell George that his patient thought he was really good? But I think we just start, need to start thinking of feedback as data. This is some data. George, we’ve got some data for you. The patients like it when you do this.

[00:39:42] George: Yes. Yeah.

[00:39:44] Rachel: I’ve also got some data for you that they don’t like it when you do that.

[00:39:47] George: Yes. Yeah. And then it’s up to the recipient, what they do with that data. Um, and I think that’s the really important piece because, you know, it, it in the context of raising concerns to another clinician, you know, there’s, there’s two phases to it. One is imparting the information and there are certain situations where it’s then over to them and, and you, I suppose to a point, your, uh, responsibility is discharged at that point of parting, you know, handing that over.

[00:40:14] George: An example might be the one I gave about not welcoming to the surgery. Now that’s not something that you can, again, knock on the GDC’s door with. It’s not something that in necessarily you’re gonna lose any sleepover. It’s just good negative feedback. It’s just, here’s a heads up, here’s something you could do that’s gonna cost you nothing, take no time, but will apparently have an impact on your patients and how perceive you. Over to you.

[00:40:38] George: Now, you may choose not to start welcoming your patients in the way that’s been suggested, or you may choose to totally overhaul how you are interacting with your patients when they walk in the door. That’s a matter for you. And that is, uh, well that’s why I love the data point, because feedback is just an exchange of information. And then how it’s acted upon is, is a, a totally separate se uh, level.

[00:40:59] George: Now, there will be occasions just to kind of go back to the, the more serious side of the spectrum where actually you are, you are invested in that data and how it’s used, and you have to follow it up. It isn’t enough to say, we’ve had reports from a couple of patients that you’re not putting gloves on before you clinically examine them. And then that’s it. I’m not gonna do anything. You then, of course, need to make sure the, the feedback’s been acted upon and, and something’s been put in place, uh, to, to make sure that’s been properly addressed. And if it hasn’t, that’s the point at which you might wanna be picking up the phone to us and taking advice on how you escalate those concerns.

[00:41:34] Rachel: Yes, I was gonna ask that. So what. Happens if you know someone continues doing that thing, you, you fed back to them about you’ve had that conversation. I heard a phrase the other day that a mistake made more than once is a decision. I thought, oh, that’s interesting. Although, I must say I made mistakes more than once all the time, you know, unknowingly.

[00:41:51] Rachel: But yeah, if, if you’ve had that behavior fed back to you and you’ve decided to keep doing it, then you do have to escalate. So what advice would you be giving if I phoned you up and said, right. I’ve had the conversation. They weren’t particularly receptive. They were a bit defensive about it, and, and it’s happened again.

[00:42:08] George: Well, let’s take it as a given that, uh, everyone listening has done the first stage, which is to make sure you’ve got an effective process in place, okay? So if you don’t have that in place, then it makes this bit very difficult because following on from the difficult conversation and putting it in writing, as I’ve uh, suggested previously, is to escalate it in-house. So that might be clinical director, it might be practice manager, might be practice principal. But whatever setting you are working in, there will be a hierarchy to some extent. There’ll be someone with whom the buck stops, and you can escalate your concerns to them.

[00:42:47] George: My suggestion at that point is put it in writing. You want an audit trail. You want to be able to evidence that you have executed your professional responsibility appropriately. Thereafter. it’s helpful to monitor it. You, you know, of course there will be situations where you are not entitled to know how things are dealt with and it, nor would it be appropriate and, and the conversation ends at you escalating it. But there will be circumstances where if you think patients are being put at risk, you do want to monitor how that’s being dealt with. And if after escalating in a local setting as far as you can, you find that nothing is being done, then it is at that point that you definitely do need to start to consider escalating your concerns to the regulator.

[00:43:33] George: But I, I would say three things before you do that. First off, you would be really well advised to speak to your indemnify, and as I’ve, as I’ve already said in dental protection, medical protection, um, we would be more than happy to have that conversation just to sense check and, and often actually, rather than sense checking what we’re doing is just exploring with you other options. Um, not necessarily saying which one to take, we’re just giving you the menu so that you can make your choice. Uh, and then I would say really read the guidance. The GDC and the GMC all have, both have their own guidance on escalating concerns to them. The types of things they deal with, um, and the types of things they don’t.

[00:44:13] George: And then the third one, uh, which again I’ve alluded to is just take a breath. There’s, there’s very little that you need to deal with absolutely there and then. Even pretty serious stuff, you can go and have a cup of tea and sit down for half an hour just to compose your thoughts. And then, you know, if, if you are left with the conclusion that it’s appropriate to raise it to the GDC, then you have to, of course, act as you think is professionally appropriate.

[00:44:42] George: It’s then a matter for you how you deal with it, with the individual. I, I’ve seen it happen both ways. I’ve seen individuals get, uh, complained about where the first they knew about it was a letter from the regulator. and I’ve had a case very recently where actually the directors of the practice wrote to the individual and said, just a heads up that we have had to refer this to the GDC. This is the information we’ve given them. We’re very sorry that we’ve had to do this, but hope you’ll appreciate the difficult position that we were placed. Um, it, it’s then a matter for you, the individual, how you choose to approach that. There’s no right or wrong. I think it depends on the relationship that you have.

[00:45:18] George: But, but really I would say in a practice setting where, unfortunately because of the management structures, invariably the person that you are complaining about, you know them personally, you’re very close to them by, by kind of nature of, of, of the proximity, you work with them in the practice. And so, you know, you can be the good and the bad guy. You can say, look, we’ve had some really difficult conversations, nothing’s changing. We have a professional obligation, we’ve had to raise this to regulator, but second part to that, appreciate that’s really difficult and we want to support you through the process. And here’s some signposting to support.

[00:45:57] George: And you know, I know that could be seen as disingenuous. I know that could be, uh, not particularly well received by, uh, the individual, but if you are raising concerns for the right reasons at the right times for the right things, then I don’t see it as totally unreasonable for those two to go hand in hand. Then you can be good and bad copying one.

[00:46:17] Rachel: Yeah, I totally agree. But the problem I’m thinking about is that obviously a lot of our listeners are gps and they’re dealing with patients that have been seen by secondary. care. And so they are spotting issues that have happened in secondary care or secondary care spotting issues that’s happened in general practice, and it’s much, much harder these days to pick up the phone and have a conversation with that person. So, although it’s not impossible, would you still be saying, look, just see what you can do to actually speak to that person?

[00:46:44] George: Yeah, I, I would, to be perfectly honest with you, um, I, I absolutely take your point about primary secondary care, proximity challenges. Um, and we see that a lot as well in, uh, dental practice, for instance, between general dentist and specialists, perhaps an orthodontist. A really good example is where a dentist has taken the wrong tooth out and they’re blaming the orthodontist ’cause it was written wrong on the referral and vice versa.

[00:47:07] George: And actually, based on my experience over the last 10 years of dealing with these cases, the ones that are dealt with much more efficiently, much more effectively for the patient, the patient gets the best outcome, the clinicians get the best outcome are the cases where the two.pick the phone up to each-other and talk it out.

[00:47:25] George: Now, the caveat to that is that you can only go so far with that, can’t you? And you, you know, busy practices and sometimes difficult to get contact details and you want to maintain professional boundaries. So yeah, I get there are all sorts of challenges to that approach, but wherever possible, I’m a huge advocate for just, um, sitting two people in one room and bashing their heads together to sort it out. And 9 times out of 10 you can do that.

[00:47:51] Rachel: Yeah, and I always think, well, what would I want if I was that person? So, you know, if I was that, um, surgeon secondary care, the GP’s noticed a mistake or something with bedside manner and you know, it, it really needs addressing, I would much rather have a phone call and say, look, I just can, I just wanted to talk to you about this. I thought it might be useful feedback for you, whatever, then, then hear about it the first time through. Either the regulator or through the hospital official liaison complaint, complaint process. But it’s hard, and it may be that I need to talk to colleagues about that and approach it together and discuss with, you know, the colleagues about how, how best to do that.

[00:48:26] Rachel: You know, I think with the best one in the world, even if someone has really, um, explained why they’re escalating and things like that, you’re, you still might feel quite pissed off or you’d feel very upset about it.

[00:48:41] Rachel: I mean, we’re not talking about the, the minor stuff. You have a conversation. Oh, yeah, okay. I noticed I was a bit grumpy that day. Yeah, I, I can change that. But we have made a big, a big error. Someone said, actually, we are gonna need to escalate this. And they have complained about you. That is, I. Really difficult on all sorts of levels. Firstly was the fact there’s a complaint going through. We talked about that earlier. But secondly, that interpersonal level, I think I would be feeling a lot of shame, a lot of embarrassment, and we know that actually when people feel shame and embarrassment, then that often comes out as defensiveness and, and arsiness and actually I could be then behaving quite badly towards that person. And I’m sure you’ve seen that as well. So what do we do when it, when it’s us?

[00:49:17] George: great question. I think first of all, if it’s somebody knocking on your door, coming to speak to you, recognize how difficult that’s been for them

[00:49:25] Rachel: Yeah. The courage it would’ve taken, right?

[00:49:27] George: Yeah, absolutely. And recognize that the alternative options were up to and including reporting you to the regulator. So as far as possible, deal with it constructively, recognizing that because the more you do that, the more they will come and knock on your door the next time, and the more you will have the opportunity to address these things at a very local level without all the unnecessary stress of that escalation.

[00:49:55] George: But also just take time out to reflect rather than going with the instinctive response because, you know, I think dentists and doctors, we are naturally high achievers. We’re so used to going through a, you know, very rigorous educational pathway that has driven us to become these almost robotic, individuals that cannot possibly face any challenge or criticism.

[00:50:23] George: And I, I know for one, you know, I, I used to, um, receive feedback really badly. I’m, I’m probably still not great. I still naturally err on the very defensive side, but I’d like to think that I have driven myself to get better at it. And my personal approach now is to just take some time out and, and really force yourself to look into the uncomfortable parts of your professional life and really, you know, reflect on the feedback you’ve been given and think actually, have they got a point?

[00:50:54] George: And you don’t necessarily have to agree with feedback in order to accept it. Do you, if you go back to the data point, you know, you, you can receive it, you can thank the individual for it, and then you can store it away in a metaphorical draw and not necessarily do anything to act upon it. Because some feedback will be, you know, if we use my example earlier, if the patients don’t like the way you’re greeting your patients, some patients might love that, or some patients might come to you because you are a little bit less small talk and you get on with things.

[00:51:23] George: So you might decide actually, well that’s fine. If they want to have that, they can go and see you. You know, that’s the benefit of the fact we both work here and I’ll stick with doing things my way. I’ve got no issue with that. And I think that’s important that you recognize that not all feedback needs to be acted upon.

[00:51:38] George: But also I think. Having that courage to alter your approach and to, to think okay, yeah. Uh, feedback from my, uh, nurses, for example, that I’m abrupt in how I speak to them, um, I’ve now had that feedback. It’s on me to, from this point forward, make a real conscious effort to fix that.

[00:52:00] George: And you mentioned earlier before about, two mistakes being, uh, intentional, and that’s me paraphrasing your words, but also a lot of clinical practice is habitual. You know, if you’ve been in practice for 20 years, you will be able, you’ll have a particular patter. You know, I remember I used to say to patients the same phrases we’d moan about the weather, my nurse would roll her eyes because it’s, God, I’ve hear, I’ve heard this script 30 times today already.

[00:52:26] George: So to change that, to change that approach based on that feedback, is really difficult. So don’t expect instant results either. Um, but be prepared to work at developing and improving. And if that means, you know, an a, a criticism of your clinical practice, be prepared to go and go on a course, do some CPD, you know, address those shortcomings, maybe work with the person giving you the feedback to see how they can support you. ’cause if they are supportive enough to knock on your door and have that difficult conversation, then I’d bet some decent money, they’d be happy to support you to address it as well.

[00:52:57] Rachel: I think the phrase that’s coming to me is that feedback is a total gift. So you’re right. If that person is taking the time to do that, then they’ve, they’ve stepped up to do it and you need to listen. Uh, the problem is, just like you said, in, in medicine, it’s all about are we perfect or not? And you know, the way that we’ve been trained, you gotta get every single answer right, every single diagnosis right, and never fail and never get anything wrong.

[00:53:20] Rachel: And so when you are, when you get the, the, the data that actually you have done something that’s caused other people pain, possibly or, or suffering or distress, a you feel really bad ’cause you don’t wanna ever call anyone cause anyone suffering or make a mistake, so there’s that like, oh no, I’ve done harm to somebody else. Or That’s not worse. There’s that. But then there’s the shame of, gosh, I’m not good enough, I’m not enough. And when you’ve been judged all your life by what you produce, what you do, how good you are, then that’s really hard to cope with.

[00:53:48] Rachel: And, and then the first thing we tend to do is become very, very defensive and try and explain why we did it. And I remember when I would get complaints, the first thing I’d just look back and make sure it wasn’t my fault. Make sure I didn’t do anything wrong. That’s all well and good, but actually what if I had done something wrong? I need to be able to tolerate it when I am in the wrong because I know I can change. But we really struggle with that.

[00:54:10] George: We do. And, and I think what we need to do is normalize mistakes and normalize complaints, and try to remove some of the stigma. And I think the dentist that tells you they don’t get a complaint, it’s one of two things. Either they’re lying or they don’t have an effective process in place to capture them.

[00:54:30] Rachel: One thing that I’ve noticed as well is, um. my instinct would be if someone comes to tell you about, gives you some feedback, like, okay, well let’s, let’s just keep this very confidential, but thank you for telling me. And you know, I’ll change whatever. But actually when I have shared stuff that’s gone wrong, times where I think I’ve really mucked up, when I’ve had negative feedback and stuff, it’s made me feel so much better. And I ended up, I end up now sharing it on the podcast with thousands of people.

[00:54:57] Rachel: But it’s so helpful. Brene Brown says, shame cannot survive being spoken. So the minute you tell someone about the mistake you’ve made or the feedback that you’ve got, it just dissipates. ’cause everyone goes, oh yeah, that’s helpful. Yeah, what you gonna do? And gosh, that happened to me.

[00:55:12] Rachel: And interestingly, in all, all the emails we get from people about the podcast, it’s mostly saying, oh, when you told that story about when you mucked up, oh, that made me feel so much better. And it, it really, really does. It’s uncanny, isn’t it?

[00:55:27] George: It’s, it is, and, and the the same is, you know, it’s absolutely true of, you know, things like adverse incidents. So I will often, uh, lecture, you know, newly qualified dentists and I’ll say, you know, two weeks into my foundation year, um, I was drilling a patient’s tooth and the bur came outta the handpiece and disappeared down the back of their throat. Um, and it was a terrifying moment for me as a dental, uh, a newly qualified dentist.

[00:55:51] George: But instantly you can just see that almost the relief from those in the audience as they realize. Oh, right, okay. And you survived.

[00:55:59] George: Um, and I think that’s a really nice point to kind of bring in is, is, you know, my, my GDC experience, which I’ve spoken about for me, really was to springboard to a really fruitful career. It opened my eyes to the world of indemnity. It opened my, uh, eyes to NPS and dental protection and the great work that they did to support me through that process. Um, and ultimately I’m convinced that it is ultimately what got me a job with them doing the work that I do now, supporting other dentists, because the empathy that you get from going through the process is invaluable.

[00:56:36] George: And so if I was to meet the chap that complained about me now to the GDC, I’d probably buy him a drink and shake his hand and say, thank you very much. But the serious point is he never got an apology from me. He never got a refund, and he never got an explanation of why the treatment I provided was appropriate and why, to put it bluntly, he was wrong to raise his complaint. It was misunderstanding, miscommunication. It wasn’t bad treatment.

[00:57:03] George: Him going to the GDC achieved absolutely nothing. He had to wait nine months for an answer. I had to wait nine months for an answer. And if he’d come to the practice directly, he would’ve got an apology. He’d have got a refund because, you know, I was, you know, very keen and still am on, you know, building goodwill. And if it’s, if, if that’s what it takes to keep someone happy, then I, then I will, even if I’ve done nothing wrong. So he’d have got a lot out of that. And instead, by going for that nuclear option, that opportunity was missed.

[00:57:34] George: Now, he didn’t have the benefit of being aware of all the local processes that we have, but anyone listening to the podcast, working in a healthcare role, will know what those local measures are in the processes. So really it’s a gift to go through those local process. You get much more out of it than going to the regulator, because the regulator is a very cold process that actually I think even the complainant doesn’t win. You know, it’s, it, it doesn’t really get anyone anywhere. Save them, as I say, just to, to drive that point home that there will be certainly cases that that need to go there and I’m not minimizing that.

[00:58:07] Rachel: The annoying thing about being complained about is that that’s where you learn the most. That’s where you developed the most. That’s where, you know, I looked through in my careers. It’s either where things that have not worked or failed or negative feedback that I’ve got where I’ve actually learned and changed the most. And that’s a really annoying thing about like self-awareness and personal development. You don’t develop if everyone’s telling you how wonderful you are. You do when they start telling you, well that could have been done better, or that was a bit rubbish, or this is how it made me feel. So it is a real gift, even if the person doesn’t respond like it’s a real gift at the time.

[00:58:41] Rachel: Before we finish quickly, George, do you have any other tips for what people can do themselves when they are dealing with a complaint that’s either gone to the regulator or going through sort of official channels? ‘Cause it’s such a, a difficult and anxious and uncertain time. So what would you be advising your, your members to do as well?

[00:59:01] George: I answer it more how I’d say, you know, advise a friend over coffee. So, if a friend of mine came to me and said, look, George, I’ve, I’ve got this going on. I, I would say three things. First of all, I would say take some time out to focus on yourself. It might be you take a week of leave. You know, if it’s as bad as you know, a GMC or GDC complaint, you know that’s only gonna happen at worse one or two times in your career. So it’s a really significant event. Put yourself first, take some time out.

[00:59:30] George: Secondly, speak to people about it. There is absolutely no reason why. We need to bottle these things up. It is not the career ending calamity that we will initially think it is. And so having the opportunity to draw on that, uh, support network is really important.

[00:59:49] George: And thirdly, I would say keep perspective. So, um, my back of a napkin calculation, if you see, uh, 30 patients a day, five days a week, 48 weeks a year for a 30 year career, you’re gonna see in the region of quarter of a million patients or patient interactions. Now, if you have in your career 10 serious complaints, you’ve still got 249,990 happy patient interactions. So, you know, it’s really important that when you get that Christmas card or that gift or the thank you notes, I say keep them, put them on display, and then have a box or a draw that you put them in. So when you get to those really low points, um, you can open the drawer and just be reminded that actually this is a single event. This is not you, and how it defines you as a clinician.

[01:00:38] Rachel: that. So see it as a significant event if you do get, you know, a serious complaint and yeah, and, and take the time that you need to deal with it. Yeah, I love that about talking to people. Get people on your side. ’cause if you, as soon as you share it, it takes a sting out of it. It really, it really does. It might be difficult the first time, but then, uh, you’ll feel, and you will find that people are really, really supportive of you as well. Generally people are, aren’t they? They’re like, oh, thank God that didn’t happen to me. What can I do to support you?

[01:01:04] George: Yeah, I remember, I remember telling my boss when I got my GDC letter and I built up the courage to walk in, um, at lunchtime to speak to my boss. And I walked in thinking, this is just gonna open the doors to the second tranche of, you know, negativity. I’ve had the letter and now I’m gonna get sacked or suspended or whatever.

[01:01:24] George: And, um, actually my boss just gave me a hug, you know, we had a very close friendship and said, I’m really sorry that you’ve had that. It seems really unfair. And they were from that point on right through the process, incredibly supportive. So the error I made was presupposing how they would deal with it.

[01:01:41] George: And I suppose the knock onto that, the, the, the, the point that I, you know, it’d be great to use this opportunity is if you have a colleague that’s in receipt of a complaint, yes, they sound serious. A complaint to the regulator is serious, but just remember that it doesn’t define them as a clinician. It’s part of a bigger story. There’s always context, and first and foremost, I think as any colleague would, would want to, um, support them, you know, leave the, the regulators to make the judgements, and you just be there as a friend and colleague to help through it.

[01:02:13] Rachel: we had someone on the podcast who was talking about a, a patient who died by suicide, and they felt incredibly guilty and lots of people were very supportive, but the one thing that made the difference to them was their boss saying that happened to me. And they went, oh, that was the one thing, oh gosh, it wasn’t just me. ‘Cause you feel like, oh, I’m dreadful. It was just me. So sharing, being vulnerable, telling people your story can all be really helpful.

[01:02:34] Rachel: George, that’s been really helpful and if people wanted to of contact you or find out more about the work that the Dental Protection Society or Medical Protection Society does, you know, where would you, or they want more stuff around this, where would you point them towards?

[01:02:48] George: Okay, so they can go to our website, which is dentalprotection.org or medicalprotection.org. They can access that from any country that we operate in. And we have country specific sites. On there, there is a wealth of information and resource, including access to our e-learning platform, which has a range of webinars for the benefit of members. So I’d encourage anyone with an interest, uh, to have a look on there.

[01:03:15] George: If anyone wants to get in touch with me personally, if they’ve, they’ve enjoyed hearing about my experiences, um, then they can contact me via LinkedIn. So I’m available on LinkedIn, um, or via the Dental Proection pages.

[01:03:26] Rachel: Great. So we’ll pop all those notes in the show notes and I think we are going to be doing some, some webinars, um, in association with the Dental Protection Society and Medical Protection Society soon as well. So if you remember, keep an eye out for that. Um, we’ll also make a download of the High Five conversation model available in the show notes just in case anybody wants to look further into that and explore how they might be able to use that.

[01:03:48] Rachel: So George, thank you so much for being on. It’s been really, really helpful. Um, and I’m, I’m certainly gonna bear a lot of that in mind. Uh, if I ever have to, you know, complain about a doctor myself or a dentist or whatever it is always, always better to have the conversation go locally and don’t escalate unless you absolutely have to.

[01:04:07] George: Yeah, absolutely. Thanks for having me, Rachel.

[01:04:11] Rachel: Thanks for listening. Don’t forget, you can get extra bonus episodes and audio courses along with unlimited access to our library of videos and CPD workbooks by joining FrogXtra and FrogXtra Gold, our memberships to help busy professionals like you beat burnout and work happier. Find out more at youarenotafrog.com/members.