Doctors vs The Law: How(Not) To Get Struck Off

Another Deep Dive. Today is a different type of issue. We have a guest writer. An actual lawyer with a specialist interest in medical law is helping us out.

Medicine vs The Law: How Not To Get Struck Off.

This is an introduction to medical law: how it quietly creeps into everyday clinical practice, and how to avoid an awkward encounter with a certain three-letter regulator whose initials may or may not include M, G, and C.

A very good read if I say so myself. Should we get into it?

Hearing.
Investigation.
Humiliation.

The process every doctor or future doc has experienced in their nightmares. 

These nightmares are unfortunately a lot closer to reality than we would all like. 

Now, imagine this scenario;

Why, in this situation, you ought to help Keanu, right? You're smart, level-headed and experienced, so why not?

This scenario was actually very real (besides Keanu). A real doctor decided to help. He also later received a complaint and was judged at an inquest.

Now, I am not saying you should not help someone in this scenario.

Lying on the road and having a trained doctor dissociate in front of you would not be ideal. But you are opening yourself up to a massive headache. 

It is tough being in your profession. I am glad my asian parents made me read law instead.

Today, I will now give you all a brief rundown on three topics relevant to a generation of doom-scrollers.

I will be your personal yet less qualified Saul to prevent ever receiving that three-letter envelope. It goes without saying, none of this is legal advice(I have nothing to give if you sue me 🙏)

Following the Devz structure of ‘who, what and where’, I will give a brief overview of the investigation process. 

This is the process behind a formal investigation:

Also, if you're bored on a Sunday evening, head over to the MPTS website. You can witness this whole process and the juicy details and drama for... Free.

So the question of the day is:

Good question, actually. Because it wasn’t long ago that young clinicians were repulsed by the concept of reading research… for fun.

“Me? Spend my time reading journals for the thrill of it? Preposterous!” 

Yet here we are, face to face(well, phone screen), pondering what it’ll take for you to engage in the cutting edge of your field of interest.

Well… we hope reading The Handover is a start. 

But one major journal got wise and realised there might be a better way to speak to young clinicians.

Y’know, to match that TikTok attention span we’ve all developed.

Introducing NEJM Clinician from the publishers of the New England Journal of Medicine. 

Every week, their team scours thousands of peer-reviewed papers published in over 150 top-ranked journals. Then:

Their summaries are short, sweet and straight to the point. So, if you:  

…you’ll probably love NEJM Clinician as much as we do.

Join those of us in the know and start using NEJM Clinician today. Click the link below for 30% off your subscription 👇

Are you a loudmouth?

It is nothing to be shy about. As nonchalant as you think you are, everyone does like to blabber. 

It is completely natural to share things about work. If your colleague farts in board rounds, are you keeping that to yourself?

If you are reading this digest, you have a basic interest in healthcare ethics. So, I am not going to sound like the nerd emoji and lecture you on GDPR or the GMC.

Instead, I am going to share some ‘data breaches’ within your industry.

Time and Place

Consider this fictional scenario;

How large do you think the investigation into this incident was? An internal disciplinary hearing would sort this out, right?

Surprise (I know, again), this did happen, and it went all the way to the Supreme Court! 

Now, from a legal background, this is a pretty big deal. Think of an internal hearing as facing Bowser Jr in World 1 and the Supreme Court as Bowser's castle in World 11. 

Basically, it can be a big deal, and you may become famous for all the wrong reasons. Not in a Kim Kardashian way.

Selfies and social media

We are all guilty of scrolling under a table. Maybe even snapping a quick selfie with the perfect bright white hospital lighting. 

It can be fun to post about work. You could even become famous. Think about the ‘12 hours after my shift’ nurse.

Alongside ocean blue scrubs, I know your profession has a reputation for serious face cards (actually uncertain about this). 

However, consider looking at the background of a selfie, you know the space around your jawline while you pose for the photo. 

A radiographer forgot to do this. Instead, their selfies repeatedly included client x-rays in the background. Which then opened them up to a whole load of investigation. 

Key takeaways 

Now this has been a massive and controversial problem recently. 

I am going to keep this section short because it is linked to the last point.

Medical professionalism is unfortunately more than smiling and shaking hands. It’s conduct during and after work. Which does include what you say on work group chats. 

WhatsApp is quick, accessible and boasts a great GIF selection. Basically, all you need is in an emergency. Perfect for your job.

There have been multiple cases where work WhatsApp group chats within the NHS get ugly. The High Court even approved that the GMC could issue warnings over it .

This is where they contain offensive and identifiable comments about patients and colleagues. 

In this situation, another three-letter regulator might step in and investigate. The ICO (Information Commissions Office). They investigate large-scale and institutional data breaches. 

They also love to keep a watchful eye on the NHS.

Key takeaways. 

‘He is finally going to talk about clinical negligence’. 

If you’ve made it this far these are probably your thoughts. Or maybe instead…

‘Damnitt, they caught me skipping section’.

I know you want to read about the big stuff on the BBC. Where someone has messed up big time. Unfortunately, that is a big and fun pile of worms that we will need to save for another time.

Fortunately, there is a whole lot to talk about outside ‘big negligence’. 

For starters, almost 80 investigations are opened a year over performance. Most due to technical surgical mistakes. I have never seen an episode of Grey's Anatomy, so you definitely don’t want to hear me try to explain anything of the sort.

However, a few cases were opened due to very common professional mistakes. 

Back to the books

A Doctor was known by their colleagues for not performing to the quality expected. They failed basic assessments and did not improve with additional training. The GMC suspended them for one year. 

The advice from this is to have a good reputation and do well in assessments! I guess you can never really escape that “life long learning” you mentioned in your medical school interviews.

Admin and honesty 

A doctor was investigated as their record-keeping was found by colleagues to be unacceptable.

It was then found that the Doctor had a track record for dishonesty. They altered patient records and lied about it. In addition, she lied about shift-swapping to get out of shifts. 

Combined, it was decided they should be struck off.

Now, dishonesty is textbook bad behaviour. However, admin and record-keeping are something everyone struggles with. 

Considering the GMC’s strict approach, it's better to be safe than sorry when it comes to groans organisation. 

Key takeaways 

You made it!

I hope you have enjoyed this digest as much as I enjoyed writing it. 

Although being struck off is exceptionally rare, as professionals and aspiring professionals, it's important to note one thing. 

In an age of NHS criticism from political agendas and private healthcare enthusiasts. Where a complaint can be publicised through pressing a simple button. Regulators are pressured to strictly watch GPs. 

Meaning that, unfortunately, all eyes are on you(GP’s and hospitalists alike).

However, there is always support if you look for it. Avoiding complaints and investigations is achieved through constant improvement. 

Completely reading this article is a good first step, so well done!

Thank you for your time.

Handover Over 🫡

Thanks for reading. We’re always trying new ways to bring stuff relevant to your career. I hope you enjoyed it.

Thank you to Ryan Kanagasabai for your write up and contributions.

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