Insights from iO’s Georgina Leelodharry at COPA

I feel better about the prospect of a complaint today than I did 6 weeks ago, and the reason is that I attended a talk on consent by iO’s Georgina Leelodharry.  Her job title is Head of Membership Services, but she spends most of her time talking about complaints against osteopaths.  Hear that? Most of her time! Whereas to us a complaint is a one-off career-threatening catastrophe, it’s all in a day’s work to her.  And Georgina seems just the kind of cheerfully brisk woman you would want on your side in that dreaded event.

Now I must confess that I have had occasion to speak to Georgina myself in the recent past, when a patient had a prolonged and unexpected treatment reaction to a seemingly harmless soft tissue technique.  Racked with guilt and concerned about what to do, I called iO and was put through to Georgina.  She rattled through what I imagine were standard questions (Had I reflected upon it? Reflected? I could think of nothing else. Had I changed the way I practised? Had I? I was never doing that technique again!  There’s  probably nothing wrong with the technique, she replied, Mary Poppins-style, it’s just affected your confidence.) She then asked me to write down everything that had happened and send it to her so she could find an osteopath to talk to me.  Meanwhile I was talking compulsively to every osteopath  who could bear to listen to me, and probably quite a few who couldn’t, and I managed to get a bit of perspective.  I did send the info to her and  added a note saying that I felt a lot better having spoken to lots of people, and I never heard back from her.   I felt that this incident was a rare event, and certainly it was the first time in twenty years of practice that I had had recourse to seek support like this.  However, as she peered at the gathering of osteopaths in the temporary little lecture room at COPA, she announced that she’d probably spoken to lots of us before.  Lots of us?  This was a surprise.  I had the impression from an NCOR study that we had a one in eight chance of having a complaint made against us during our entire career.  Why was she talking to so many of us?  I guess maybe there were lots of worried well like me, or potential complaints that never ended up with the GOsC?  It said in the COPA blurb that Georgina “has an excellent record for helping members to avoid complaints escalating to legal action or regulator involvement”.  It certainly sounds like it .

We listened with fascination as she breezed through her guide to consent, illustrated with a variety of anonymized true life stories.  I could have listened all day.   She covered the full spectrum from the trivial to the horribly serious.  Two osteopaths have been struck off over the past three years.  These were for sexual misconduct.  I know that one actually committed a crime and went to prison.  Well that is some consolation for me.  If you have to commit a crime to get barred from practice, at least I know that even on my worst day there’s no risk I’ll absent-mindedly defraud an insurance company or sexually assault someone.  But we also heard about the sorts of people who phone to complain that the towels hadn’t been warmed, or that the osteopath did not walk them to the front door to show them out.  (Yes, genuine calls which did not progress to the regulator once Georgina had explained that it did not sound like a breach of the Code of Practice.)   People have called to complain that the osteopath has just talked and not done any treatment.  (I must say that I think I’m on the side of the patient there.)  There are also callers who are simply confused as they were not expecting to get undressed, or because this osteopath was totally different to their last.  Osteopathy is such a broad church that patients might find it confusing that the last therapist sat with their hands on her head for half an hour, and the next one is undressing them, crossing their arms, and leaning heavily on them till their back cracks.  This type of call generally comes after the first appointment, and it is here that talking and explaining and more talking and more explaining and then even more explaining will help.  There is also the occasional caller who is after money (“Give me £4000 and I won’t go to the GOsC”).  And there are times when osteopaths do get it wrong:  she mentionned two punctured lungs (acupuncture needles), and a stroke (HVT), where the insurance company did pay out. But in between the non-warmed towels type of call and the call that sparks a criminal investigation there is a huge grey area where it might not be so obvious if you are at fault or not.  This is where you have scope firstly to make sure your patients are happy and confident in you and don’t want to complain, and secondly, to ensure that you have practised safely and professionally AND SHOW THIS IN YOUR NOTES in the event that you are unlucky enough to be on the receiving end of a malicious or mistaken complaint.

(to be continued – next time, learning about CONSENT)