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Poor working conditions 'having a negative effect on doctors' ability to communicate with patients'

One in five complaints made to the Medical Council related to communications issues.

LONG HOURS AND poor working conditions are having a negative affect on doctors’ abilities to communicate effectively, according to the president of the Medical Council.

The Medical Council’s annual report published last week found that nearly one in five, or 19% of complaints against doctors related to communication issues. 

This figure was in line with the same statistics in previous years and the council said it was taking measures to ensure communication skills was a mandatory part of doctors’ continuous professional development. 

At the launch of the council’s five-year strategy at its Dublin offices, Dr Rita Doyle said the knock-on effect of recruitment shortages and “high-pressure” working conditions was taking a toll on doctors’ abilities to communicate effectively. 

“[Communication issues] go right across the board in every branch of the profession,” she said. 

“If a doctor is tired at the end of the day and says something rude, or something like ‘not you again’, or something like that, then the patient makes a complaint.

“What the patient doesn’t realise – and it’s not their job to realise – is that you might be patient number 42 today and everybody is so busy, it’s just human.”

Doyle said the understaffing of the public health system has contributed to the number of patients making complaints as doctors come under pressure from extra workloads left behind by the unfilled positions. 

“There aren’t enough [doctors] in any branch of the profession. We’re minus 500 consultants within the hospital services and [filling those] wouldn’t even bring us up to OECD standards, it would just bring us back to where we were.

“The under-staffing of the whole health service is one of the biggest issues in the health service.

“You say ‘my list is full I cannot take anymore’ and the next thing is you’re assigned more [patients]. You don’t have a choice and that’s not the way to do business. 

“I think doctors health is hugely relevant here – you wouldn’t let a pilot fly a plane if he was working or 19 hours.”

The annual report for 2018 showed there were 22,996 doctors registered with the council and 396 complaints received. Five people were struck off the register.

‘Misconception’

Doyle said that 58% of the doctors registered with the Medical Council were Irish-trained but that there is a misconception among the public that the majority of complaints are levied against foreign-trained doctors. 

“There’s a misconception that is out there but there are not more non-Irish doctors struck off, and there are very few overall if you think we’ve a population of 23,000 doctors, to only have five in a year to be deregistered.”

She cited the case of a Sudanese doctor who made headlines when he confused an ankle with an elbow three years ago, as an example of the public perception that foreign-trained doctors cannot communicate in the same way as Irish doctors. 

“I think the media are somewhat to blame, I think that doctor that confused the elbow with the ankle that was such a high-profile and unusual situation, but when doctors are trained outside of the EU, it is very difficult to assess their level of competence. 

“Once they are eligible for registration that’s what we do, we mind the register, we’re the custodians of the register but it’s up to the employers to decide if the doctor they have employed is competent in interview processes.”

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