Fitness to Practise Learnings: Professional communication
A recent case illustrates the importance of empathetic and professional communication when your views differ from those of a patient.
By law all complaints received by the GCC must be considered by an Investigating Committee (consisting of both lay and registered members). Their role is not to decide on the details of the case, but decide whether there is a case to answer:
Would the conduct (if proven) be unacceptable professional conduct?
- Is there enough evidence to make a case?
- Is it in the public interest to consider the case?
- Where they find a case to answer, it is put forward to a full hearing of the Professional Conduct Committee (around 12 cases a year).
While the majority of IC cases are closed with no further action without comment, occasionally the IC will find there is no case to answer, but nevertheless use the opportunity to provide advice to the registrant. This advice will not be recorded on the public register, as it is not a formal sanction, but the fact that advice was issued may be called upon if another complaint is made against the same registrant.
Background to the case
This case concerned a disagreement between a first-time patient and a chiropractor after the patient revealed that they were ethically vegan (an approach that did not align with the chiropractor’s strongly held view that it is necessary to eat meat to be healthy). The chiropractor considered that their veganism explained aspects of the patient’s appearance.
It was clear from the evidence that both the patient and chiropractor held, and expressed, strong personal views, but the continuation of the discussion across a series of emails – including after the patient had cancelled the next appointment, and made a complaint to the clinic – that formed the body of the complaint.
While a patients’ diet is a legitimate subject for discussion during an appointment as it could have an impact on their health, it is the chiropractor’s responsibility to work with and respect the patient's personal views and decisions.
The Code states the chiropractor should:
- A1: show respect, compassion and care for your patients by listening to them and acknowledging their views and decisions. You must not put any pressure on a patient to accept your advice.
- A2: respect patients’ privacy, dignity and cultural differences and their rights prescribed by law.
- C5 – select and apply appropriate evidence-based care which meets the preferences of the patient at that time.
- F5: listen to, be polite and considerate at all times with patients including regarding any complaint that a patient may have.
Investigating Committee Finding
The IC found that, while the registrant had demonstrated a significant degree of rudeness and lack of empathy towards his patient, and had not offered any apology for the distress they caused, there was no complaint about the treatment they delivered and their behaviour, although repeated, involved one patient over a relatively short timescale.
Although in no way to be condoned, the Committee did not consider that, taken as a whole, the registrant’s conduct in this single instance would be considered by the public to constitute unacceptable professional conduct.
The IC found there was no case to answer, however they exercised their right to issue advice to the registrant. The IC considered that the Registrant might reflect on lessons he could learn from this complaint, in particular the need to communicate effectively with patients to establish and maintain a professional relationship, respect patients’ individual choices, listen to them and acknowledge their views and decisions, regardless of their own opinion.
Further reading
Further advice on Enhancing Patient Care Through Effective Communication was previously published by the GCC as part of our Professionalism in Chiropractic project.