Feature 
  
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Sham Peer Review request 
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Genuine concerns about doctor 
  
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Investigation of the complaint(s) 
  
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Done poorly or not at all 
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Investigation done more carefully 
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Time pressure 
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Putting pressure on doctor to answer the complaint very quickly, without
  access to records and within a couple of days e.g. on weekend for complaint
  made on Friday. When this is complied with, refers to regulator anyway. Does
  not seek clarifications from doctor if not happy with a reply. Poor conflict
  management skills. 
Pulls doctor out of the clinic while seeing patients for an urgent
  meeting to answer a non-urgent complaint because “busy” at other times. 
  
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Given reasonable period to respond 
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Hoarding of minor complaints 
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Complaints not disclosed to doctor on time but reserved to hit him/her
  with several complaints at once. 
Habitual stacking of complaints and issues not dealt with. 
Pathological avoidance of situations which may give rise to a difference
  of opinions. 
Pathological fear of conflict.  
  
  
  
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Complaint(s) disclosed promptly to doctor to answer 
  
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Abuse of poor policy or
  process 
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On reading regulator’s faulty policy e.g. policy which has features
  of indirect discrimination against a group of doctors (like those who are
  contract workers or in private practise) decides to use this to get rapid
  access to the regulator 
  
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Not used 
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Language of serious concerns 
  
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Complaints written in a way to maximize the interest of the regulator
  in the absence of harm to patients: “I have serious concerns about Dr……” 
  
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Evidence of harm to patient or potential harm to public presented
  after thorough investigation and when other options are not feasible 
  
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Emotional abuse/humiliations 
  
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Statements as to the mental health of the doctor in the absence of
  any medical evidence or reference to the internationally accepted criteria.
  No referral to Occupational Health or any reference to doctor’s medical
  practitioner. 
  
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Refer doctor if ill to Occupational Health promptly without referral
  to regulator and ensures right questions are asked and answered. Patients
  protected by use of locum doctor to cover absence due to illness  
  
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Gain 
  
  
  
  
  
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Preservation of own reputation takes precedence over lives of others. 
Sham peer review serves as a cover up of own wrongdoing 
  
  
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No gain from making a referral to the regulator 
  
  
  
. 
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Honesty 
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Prepared to lie on oath. Tries to cut a deal so to avoid giving
  evidence on oath if written statement is accepted 
  
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No need to make false allegations has evidence to back the complaint 
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Staff turnover 
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Higher than average staff turnover and a more frequent user of
  regulator’s services  
  
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Normal staff turnover 
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Culture of bullying 
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Over the period of years bullies tend to surround themselves with bullies.
  Authoritarian approach, dislike of dissent 
  
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Complaint politely submitted outside the culture of bullying 
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Manipulation and status
  seeking 
  
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Infiltrate medical establishment as additional means of self-protection.
  This may involve the regulators themselves i.e. starts to work for them. 
  
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Has no need for self-protection from within the regulator 
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Outcomes for patients after
  dismissal of doctor 
  
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Deterioration in the outcomes for the patients when excellent doctor
  is dismissed and not replaced 
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There can be an improvement in the outcomes for the patients when
  incompetent doctor is removed even temporarily 
  
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Chronology of referral 
to the regulator 
  
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Referral follows after whistleblowing, or threat to the egos, or fear
  that disclosure may occur more widely outside the organization, or due to
  business rivalry or dispute, or after a court case taken by the doctor
  complained about 
  
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Referral follows from events related to poor patient care 
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Concerns about conduct of the
  doctor 
  
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More likely to be concerned about the conduct of the doctor, claims disruption.
  Provokes disruptive behaviour by doctor in a variety of ways such as frustration
  caused by passive aggressive behaviour of hospital administrator or others 
  
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Concern about patients’ welfare  
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Allegations 
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False and numerous, gossip, hearsay. Witness Statements that get
  withdrawn because witnesses unwilling to give the evidence once the process
  is in full swing and about to be heard in public 
  
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True complaints backed by Witness Statements 
  
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Person who makes false
  allegations 
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Sham peer review complainer is protected by medical regulator.
  Determinations by medical regulator do not give the names of, for example,
  medical directors who made false allegations to regulator and initiated the
  process of sham peer review. The names of the witnesses who gave evidence for
  doctor are published. 
  
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No backtracking  on Witness
  Statements or secret allegations or little chats with investigators at the
  regulator that accused doctor never hears about 
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Wish to do harm 
  
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Despite all the bad intentions that started the complaint process, at
  the disciplinary hearings before the regulator the accusers feign surprise
  that things got that far for the accused doctor. “I did not mean it”. Denial
  in contrast to the actions taken and the knowledge what the outcomes of those
  actions could be. 
  
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Patients are real concern 
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Protectionism 
  
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Protects either himself/herself and/or other colleagues he/she thinks
  cannot live without-feels compelled to work with them 
  
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Protects patients 
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Medical records 
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Withholds medical records and even when asked by the regulator sends
  only bits of the medical records at the time. Disclosure of one single
  medical file can take years. Regulator despite their powers to order
  immediate and complete disclosure is complicit with delay. 
  
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Sent promptly to regulator and doctor 
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Fraud 
  
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The accusers may be involved in fraud, sometimes widespread. 
Prepared to send even completely different patient’s records from the
  case complained about to the regulator. 
  
  
  
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No evidence of financial or other gain to be made by discrediting the
  doctor 
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Mobbing 
  
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Engages a crowd of people to act as complainants in order to hide
  behind them. Creates impression of widespread concerns to engage the
  regulator. 
  
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No need to have numerous witnesses to misconduct 
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Concealment of evidence 
  
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Documents missing, denies existence even when one document states
  another one is attached to it and staple marks are present. 
  
  
  
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No need to conceal the evidence 
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A User of others 
  
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Prone to prejudice and could use those considered inferior to write
  the complaints so as to avoid personal responsibility. Hides behind others.
  Divide and rule. 
  
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Not present 
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Phoning around to get more
  troops 
  
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Telephones previous employers to get them to complain as well.  
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Not present 
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Pseudo consultations 
  
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Engages in pseudo consultations to get the “green” light to make the
  complaint to the regulator. For example, telephones National Clinical
  Assessment Authority for advice but actually trying to find if there are
  other complaints there already against the doctor. Calls other employers who
  also engage in pseudo consultation with Clinical Assessment Authority 
  
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No hostile dependency on other public bodies to get the support to
  report to the regulator. 
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Personality type 
  
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Snakes in suits 
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Unremarkable, no delight in harming others 
  
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