Dr charlie teo fights malicious complaints system

Dr Charlie Teo fights 'malicious' complaints system | Australian Doctor

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⋆ Today's Top Picks Developing rapport with teenage patients Neurosurgeon Dr Charlie Teo says he is a victim of vexatious claims, including that he had urinary incontinence.

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Dr Charlie Teo fights 'malicious' complaints system Tessa Hoffman and Paul Smith

| 28 April, 2016 |

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On a crisp autumn day in Sydney, a medical conference is underway.

Inside the small, dimly lit room at the Novotel in Darling Harbour, conference-goers swill down takeaway coffees before edging their way to their seats, and a sound man makes last-minute adjustments to a microphone.

But this is no typical medical conference.

The meeting of around 100 health professionals will hear from an assortment of doctors and nurses who claim to be victims of their colleagues, aided and abetted by the myriad health regulators and medical investigators there to protect the public from harm.

They come with war stories, some seem heart-wrenching; stories of lives and careers destroyed, of reputations ruined. Many of these stories, because their narrators name those they blame, are unprintable under Australia's current defamation laws.

Related: • Doctors share harrowing bullying stories at conference • Complaints system is destroying lives, says doctors' group It has been organised by the Health Practitioners' Australia Reform Association (HPARA), which

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was founded last year by several doctors, including chairman and retired thoracic physician Dr Don Kane and outspoken Melbourne paediatric surgeon Professor Paddy Dewan.

Professor Dewan, who consults at Ringwood Private and Geelong hospitals, was reprimanded for unprofessional conduct in 2012 following surgery on an eight-year-old. He has has battled regulators through the courts for more than a decade and claims there is a "disease" in the regulatory system, which requires a Royal Commission to find the cure.

"Harm has been done to practitioners who have been put through the mill, and also patients who have been hurt by making complaints that were not dealt with appropriately [by regulators], like the case of [jailed anaesthetist] James Peters who gave 55 people hepatitis," says Professor Dewan, who claims his own career was badly harmed by a vexatious complaint to the Medical Board of Victoria.

"When medical treatment is debated through legal argument, developments in medicine are hindered because legal argument does not produce the best medicine."

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Dr Charlie Teo fights 'malicious' complaints system | Australian Doctor

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Related: Senate to investigate AHPRA over alleged bullying of doctors His aims are ambitious. Reform will need to stretch right across the system, from the coroners courts, the tribunals and the health commissions to AHPRA and the medical board itself.

All use adversarial-style systems that lack transparency and accountability, and do not take the welfare of those at the centre of their investigations into account — at least that is what Professor Dewan says.

Rebels with a cause There are some familiar names at the conference. We hear from Dr Gabrielle McMullin, the consultant vascular surgeon who courted controversy last year with her famous "blow job" comments, which sparked a media storm that ultimately exposed the harassment that continues to exist within the speciality.

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She repeats her claims that the surgical profession is a ‘boys' club', riddled with sexism and nepotism.

"Merit is decided by a group of men … and in their eyes, merit is a white heterosexual man. The only difference women can make in this process is by sex.

"Sex is a commodity and women can use it. I know women who have been given prestigious jobs by certainly submitting to sex," says Dr McMullin, director of South Sydney Vascular Centre.

Related: • Inquiry to investigate doctors' vexatious claims • Doctors' fears of medical board 'unfounded' Then comes Dr Charlie Teo. In the public mind, Dr Teo (pictured above) is largely seen as a hero, the neurosurgeon giving hope and renewed life to the patients on whom his colleagues are usually unwilling to operate.

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But the motorbike-loving surgeon, famed for his keyhole surgery to treat brain cancer, is seen more sceptically among those who would profess a more sober attitude to cost-benefit analysis.

Dr Teo says he's been vilified within the medical profession since abandoning a successful career in the US to come home to Australia.

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He alleges his opponents have used slander, litigation and vexatious claims lodged with the state and national health regulators to try and destroy his career.

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At one point, it was suggested that he should not be allowed to practise because he had urinary incontinence, he says.

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"That all was generated because I did a case that took me a long time, 14 hours," he tells the audience.

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"I had saline and blood all over the front of my gown and when I took off my gown I go, ‘Oh my God, it looks like I wet myself'. So it was reported that I urinated during the case. I had to go through the humiliating situation of having to write and get a urologist to say I am continent."

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Dr Teo, who is director at the Centre for Minimally Invasive Neurosurgery at Prince of Wales Private Hospital, Sydney, says he's been told the reason he evokes such animosity is because he is a self-promoter and has an "attitude problem".

He says he has developed a litmus test to predict a doctor's likelihood of being bullied by ruthless colleagues. His barbed humour is met with loud cheers and applause.

The most likely doctors to take a hit, he claims, will display some of the following characteristics: overseas trained, trusting and naive, bulk-billing, caring and compassionate.

Those doctors who show the qualities of the "pugilist", the "incompetent", the "bully", those doctors who "charge AMA rates or higher" are safe as houses, he smirks.

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Dr Charlie Teo fights 'malicious' complaints system | Australian Doctor

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Melbourne paediatric surgeon Professor Paddy Dewan has battled regulators for more than a decade. He says it will take a Royal Commission to resolve the issue. Photo: Nic Bezzina

Vexatious complaints During the break he explains to Australian Doctor why he's joined the push for reform.

"I wanted to try to right some of the wrongs I have seen in the system over the years. The carnage of fellow neurosurgeons who I felt had been wrongly done by.

"Many of the people you see today have had their privileges revoked, had their registrations revoked and these are good doctors ... the public would benefit if they were practising doctors today. I'm here mostly on their behalf."

It all boils down to fatal flaws in the regulatory system, he claims. "[The system is] malicious and it allows doctors who should be under review, like the Butcher of Bega [former NSW gynaecologist Graeme Reeves, who was jailed for mutilating a woman's genitals], to get away with it.

"There are no safety nets to stop vexatious complaints. The people who are making the complaints are in competition with these victims, and when they are found guilty of vexatious complaints and spurious complaints, they are not punished for it."

‘Sham peer review' There are two concerns underpinning HPARA's argument for reform. The first is the way peer review — particularly in the hospital system — is used to target unpopular doctors.

Dr Larry Huntoon, former president of the Association of American Physicians and Surgeons, calls it "sham peer review". He tells the conference it is used by hospitals around the world to identify non-existent problems with doctors.

Related: • To err is human • Are AHPRA's Big Brother powers justified?

The real motivation for the process can stem from professional jealousy, the desire to get rid of a whistleblower, or even a doctor who doesn't bring in enough cash, he claims.

Dr Huntoon's presentation seems to strike a chord with the audience.

The second issue concerns AHPRA — the system that allegedly allows vexatious complaints to flourish. This is the argument that you hear from people like former AMA president and Melbourne GP Dr Mukesh Haikerwal.

Under national law, there are legal protections for those making complaints against doctors and other health professionals. These were introduced so that whistleblowers would not require conclusive proof of incompetence or wrongdoing before they made a complaint to AHPRA. As long as they make their complaint in "good faith", under the law they could not be prosecuted for defamation if the complaint was subsequently shown to be unfounded.

The idea was to encourage people to speak up in a medical culture where certainty is rare.

Related: • Check your risk of patient complaint • All specialties urged to investigate bullying However, this has allowed the innocent to be targeted, say AHPRA's critics. Unfounded complaints are made, investigations carried out, damage done and in reality those responsible for setting events in motion are free to walk away — at least that is what is alleged.

Whether true or not, there is another point these critics make to support their case. Under AHPRA

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Dr Charlie Teo fights 'malicious' complaints system | Australian Doctor

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laws, the watchdog will also investigate completely anonymous complaints against doctors.

AHPRA says this is in line with medical complaint systems worldwide. The watchdog could have explained this to the conference delegates itself, but its CEO Martin Fletcher, who was invited to enter this lion's den, declined after he was told he could speak from the floor, but could not give a presentation.

Seeking justice Some of the personal stories told at the conference are so complex and peppered with so many contested allegations they are unpublishable for legal reasons. This is what happens when your core allegation is that the mechanism for deciding truth and falsehood, guilt and innocence — the regulatory process itself — has been corrupted.

But some stories are straightforward.

Nurse Jane Thompson (pictured left) says she suffered PTSD after enduring a gruelling six-year investigation by health regulators in NSW. While she was finally exonerated, the battle to clear her name cost her tens of thousands of dollars and damaged her career, family and mental health, she claims.

The investigation started after a patient died at a Sydney hospital, the day after a caesarean birth.

Ms Thompson was the anaesthetic nurse in charge of the woman's care immediately postsurgery.

Ms Thompson says she received death threats when the case hit the media, and was brutally cross-examined for four hours during the 2009 coronial inquiry.

After the inquest, the Health Care Complaints Commission (HCCC) lodged a complaint. She was cleared, the HCCC appealed, but Ms Thompson was exonerated a second time. The ordeal took its toll, not only on her career — but also her family life.

"My kids were four and six when it happened and I don't really recall them growing up."

She claims she is owed an apology and financial compensation.

"There has been no justice and that is why I am here."

Start of a solution Professor John Whitehall, a professor of paediatrics and child health at Western Sydney University, takes to the stand to close the conference, issuing words of caution.

This campaign must be fought using documented evidence, he says.

"We need to use data, not emotion, to back up our arguments."

As HPARA's inaugural conference wraps up, Professor Paddy Dewan is optimistic.

"The best thing about it is the feeling in the room," he says.

"There is a real intent for people to identify the problem, to say this is happening and it's ruining the lives of health providers and patients. I have the impression people feel like this is the start of a solution."

Tessa Hoffman is an Australian Doctor reporter and Paul Smith is deputy editor. « Previous | Next »

Read more about: Medicolegal, Regulation, AHPRA, GP stories

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