A Psychiatrist In Fife #3
Summary
This post concludes a series about a ruinous incident that occurred with a psychiatrist, who wrote a letter, without meeting me or speaking to me, which claimed that I have ‘Factitious Disorder,’ and that my facial pain is ‘fictionalization.’ He published this letter on my medical records. I discuss the devastating impact that this incident had on me personally, and the response that I received from The General Medical Council to my complaint about this psychiatrist and his actions.
Fitness to Practise
The General Medical Council, (GMC) only investigates complaints about doctors, whose fitness to practise is in question.
‘Doctors have a respected position in society. Their work gives them privileged access to patients, some of whom may be very vulnerable. A doctor whose conduct has shown that they cannot justify trust placed in them should not continue in unrestricted practice. The public is entitled to expect that their doctor is fit to practise and follows our principles of good practice described in Good Medical Practice.
Most doctors measure up to these high standards, but a few seriously fall short and put patients at risk, cause them serious harm or distress, or undermine public confidence in doctors. For that reason, we have legal powers to take action.’[1]
GMC Regulation
The General Medical Council are unlikely to indicate a fitness to practise problem with one-off mistakes. ‘It is serious or persistent failures to follow guidance that will put a doctor’s registration at risk.’[2] The behaviour which could call a doctor’s registration into question are;
- A doctor’s performance has harmed patients or put them at risk of harm.
- A doctor has shown a deliberate or reckless disregard of clinical responsibilities towards patients.
- A doctor’s health is compromising patient safety.
- A doctor has abused a patient’s trust or violated a patient’s autonomy or other fundamental rights.
- A doctor has behaved dishonestly, or in a way to mislead or harm others.
My Complaint
My complaint to the General Medical Council was that this psychiatrist wrote a discriminatory letter, without having met me or spoken to me, which led to me being refused medical treatment for my facial pain. I complained that his letter was misleading, and breached Good Medical Practice, (71 and 71a.) The psychiatrist defended his actions with a brazen argument, claiming that he wrote this letter ‘to keep me safe.’ Keep me safe?
It didn’t keep me safe. It pushed me to the edge of the cliff.
The GMC opened a provisional enquiry. They obtained further information to see if the case required a full investigation, or whether it could be closed down. From the information they acquired, they did not find this psychiatrist unfit to practise.
The psychiatrist had apparently acquired the info that I had ‘factitious disorder’ from my notes. During a two-week admission on a psychiatric ward, (which I had requested,) the locum psychiatrist on the ward, who I saw only twice, said that he thought that I had Factitious Disorder. This psychiatrist took that information from my notes. However, what the GMC missed was, that he wrote this letter without arranging an appointment with me first, to ‘check that the information was correct,’ (Good Medical Practice, 71a.) A warning should have been given to him, to take greater care, re diagnosing patients without meeting them.
What was shocking, was how the GMC manipulated my complaint to support their argument. In their outcome report, they said that I had complained that the psychiatrist had written the letter, without looking in my records/notes. I did not say this. I complained that he had written it without meeting me. The GMC twisted my words to support their defence of the psychiatrist’s actions. I didn’t appreciate being manipulated like that.
Protecting Public safety?
The role of the GMC is to protect public safety. However, I do not feel that they have protected patient safety on this one. This psychiatrist did a) show reckless disregard of clinical responsibilities towards me, b) he violated my autonomy and two of my human rights (fundamental rights) and he c) behaved dishonestly, and in a way designed to mislead others.
By the GMC choosing to defend the psychiatrist, he will likely cause another patient immeasurable harm in the future. That is not protecting public safety. It is protecting the actions and status of a crooked doctor. However, being silenced by a supervisory body is tough. It is impossible to challenge their decision, even with the anomalies.
Twist
The manner in which the GMC twisted what I had said, is consistent with my experiences of complaining to supervisory bodies. My know-how of complaining to regulatory bodies, like NHS England and The Parliamentary Health Service Ombudsman, (PHSO), is that they will often bend the tenet of the complaint, to protect the big guy. Quashing the little guy, who has no power, is easier than standing up to a bully, who has an army of defence behind him.
The System
In On Shame, I said that the system is broken. The fact that I am suffering with unrelenting facial and orbital pain, for which I cannot get treatment, is torturous enough. For there to be a letter on my Scottish medical records, written by somebody who has never met me or spoken to me, which claims that I am ‘making all this up to get attention to feed the need for a sick role,’ which no professional has questioned, and which the General Medical Council has excused, makes the system, not broken, but rotten to the core.
Impact
This letter nearly killed me. By writing these incriminating words, this psychiatrist closed any treatment doors that I had opened, by the courageous act of moving to Scotland. Things were going well. My GP had referred to Ear, Nose and Throat. He believed me. However, after this letter was published, I was looked upon as filth by the medics. He backed me into a corner. I had no room for manoeuvre. This incident pushed me into an acutely fragile state, and if it had not been for the support of the charitable sector, I would not have made it.
Coward
This psychiatrist left the position as locum psychiatrist, three months after he published this letter about me. He planted an explosive. He watched it explode, but he didn’t stick around to clear up the mess. I faced obscene mental health discrimination from medics as a result of his letter, and the fact that he was nowhere to be seen when hell broke loose, was a shameful act of cowardice.
Leaving Fife
As soon as the second lockdown lifted, I scarpered. Before leaving Scotland, I telephoned my GP Surgery, to find out if they had entered Factitious disorder onto my medical summary. Thankfully, because the psychiatrist had never met me, and I had received no psychiatric assessment, they had not entered it under any of my diagnoses. Factitious disorder is not on my medical summary in England either. Even though, now that I am back in England, this discriminatory letter has no power over me, I want it removing from my Scottish records on principle. I do not have Factitious Disorder, or any such disorder. This letter, therefore, has no place, on any of my records.
On Trauma
I experienced trauma, both as a child and teen. My experience of trauma is that gradually, over time, it softens, and has less hold over you. However, the shock of this incident has not thawed. It still feels as raw as it did when it happened, three years ago.
I lived in San Francisco during my twenties. Minor earthquakes, that don’t reach the headlines, regularly occur there, because it is situated close to The San Andreas Fault. After the tremor, parts of the landscape; trees, fences, lampposts, may change shape. That damage never repairs.
Since the day that the ENT consultant told me about this bigoted letter, something within my inner architecture has dented. I am on constant high alert and constantly looking over my shoulder. This incident has charred my trust, and I am not confident that this will ever heal.
Betrayed
I know the terrain of abuse and betrayal well. My parents consistently busted my boundaries. As a consequence of their behaviour, many others walked all over me until the age of 30, when I made a difficult decision to walk away from many significant relationships.
My parents were damaged people, but there wasn’t the access back then to the psychological therapies that there are now. However, this psychiatrist was not ill. He made a dangerous judgement about me as a person, without meeting me, which he has published on my records, and which adversely affected how medics viewed me.
My mother may have failed me in many ways, but what she couldn’t provide with affection, money, or possessions, she imparted with extraordinary values. She raised me to honour fairness, resourcefulness and honesty. This psychiatrist has not only undermined my integrity, but he has insulted my late mother’s legacy, which makes this, by far, the worst betrayal that I have ever experienced.
A Tribute
I want to pay tribute to the non-statutory organisations who supported me through this catastrophic incident and the consequences that ensued from it. A heartfelt thanks goes to The Bethany Christian Trust, (Housing Support, Fife) and Breathing Space; the national helpline in Scotland.
I was treated as less than human by the statutory services in Fife. They kicked me lower than I thought it humanly possible to fall. Thank you for the respect and dignity that you showed me. Your kindness helped me to find fleeting moments of self-worth in a period of darkness and chaos. The work that you do in society is heroic. On behalf of myself, and the thousands of vulnerable people, whose lives you touch, enrich and save– thankyou.
Foot Notes
[1] The General Medical Council; The Meaning of fitness to practise, February, 2021, www.gmc-uk.org
[2] The General Medical Council; The Meaning of fitness to practise, February, 2021, www.gmc-uk.org