Meet a hearing member and read her tips on avoiding a complaint

Dr Katherine Smartt is a GP with over 25 years of experience and a hearing member for the Medical Council. In this interview, Dr Smartt shares her experience being a hearing member and offers insights into how the Council responds to complaints relating to a doctor’s performance. She also shares how the Council supports doctors to improve their practice.  

“Well, I’ve been a GP for a long time,” Dr Smartt says, “But my work with the Medical Council started when one of my supervisors from when I was a registrar suggested I apply to become a hearing member. I took the suggestion seriously and applied. I started in 2017, and I can honestly say it’s been a real privilege.” 

“When a complaint is lodged, the Medical Council looks into it to see if there’s a real concern about the doctor’s practise,” Dr Smartt says. “If the Council feels there’s an urgent risk to the public then we go to an urgent hearing and there may be immediate action taken there. If the risk is not urgent then it will usually go to a performance assessment, where a team of doctors evaluates the doctor’s overall practice, not just the issue that led to the complaint.” 

“There are some situations which may require urgent action to protect the public. Hearing members review complaints made about doctors and decide what action, if any, needs to be taken,” Dr Smartt explains. “We’re part of a panel, which includes community members as well as medical members and together we interview the practitioner regarding the complaints and their practice in general. Our job is to make decisions based on the facts of the case, keeping in mind both the doctor’s well-being and public safety.”  

Dr Smartt highlights that hearing members take their role very seriously, and making decisions requires a deep understanding of all the variables involved. “We spend a lot of time reflecting on each case. We know that our decisions impact both the doctor’s career and patient safety, so we don’t rush our judgment,” she explains. 

Often, it’s not about one incident; it’s about a pattern or a serious issue that affects patient care. The goal isn’t to punish the doctor but to figure out what’s going wrong and how we can help them improve. 

“I will say sometimes read the complaint, and think, ‘oh my goodness’, but when you go to the doctor there are clear circumstances leading to the complaint and it can be managed easily. And sometimes you think it’s a minor complaint and when you investigate there are big concerns around the doctor’s practice. Hearing members really need to keep an open mind. We always try to be fair; we’re doctors too, we’re not trying to trick anybody.” 

“When a performance assessment is needed, it’s about getting the full picture of a doctor’s practise,” Dr Smartt explains. “In many cases, this involves an on-site assessment where we review a random selection of their medical records, possibly observe them with patients, and have conversations with them to get a real sense of how they’re practising on a day-to-day basis.” 

The team conducts a thorough review, asking questions about the doctor’s workload, how many patients they see each day, and how they’re managing their caseload. But it’s not just about the professional side of things - Dr Smartt emphasises that personal factors are also taken into account. 

“We ask about things like their level of training, how they’re managing their time, and even aspects of their personal life. Stress or personal issues, like not having had a recent holiday, can definitely impact a doctor’s performance,” she notes. 

The team also wants to understand how the doctor feels about the complaint itself. “We’ll ask how they feel about the complaint, whether they feel differently now than when it was first made, and whether they’ve made any changes to their practice as a result,” Dr Smartt explains. “For instance, if the complaint was related to a missed result, have they changed the way they check results going forward.” 

The performance assessment looks at various domains of practice, such as communication, clinical assessment, patient management, and medical record-keeping.  

“It’s very common for a doctor to be strong in one area but need improvement in others,” she adds. “We focus on how they’re performing in these key areas and then write a detailed report for the Medical Council with our recommendations.” 

“If we find real concerns, we may suggest restricting prescribing rights or recommend that their practice be supervised,” she says. “Each case is different, but the goal is always to ensure public safety, while supporting the doctor.” 

The team’s approach is about working with the doctor to improve their practice. “If they’re not performing at the expected standard, we look at what would help them get to that level for their background and training.” 

“At the end of the day, our role is clear: we’re here to protect the health and safety of the public.” Dr Smartt concludes. 

“Exactly! I think that’s a really important point,” Dr Smartt agrees. “Doctors don’t always get it right. We’re human, after all. If we notice something concerning, our first step is to offer support. That could be further training, extra supervision, or simply giving them the time to reflect and improve.  

Dr Smartt also addresses a common worry among doctors who have had a complaint made against them. “Doctors are often very concerned that they’ll lose their registration when they’ve had a complaint made against them, but that rarely happens when there’s a performance complaint, because very often we can support the doctor and also keep the public safe.” 

One of the big areas we’ve seen more complaints about recently is prescribing practices, particularly with opioids and benzodiazepines,” Dr Smartt reveals. 

“It’s a complicated area, and I think a lot of doctors are trying to help their patients but perhaps not always doing so in the best way. Our understanding of pain management has changed significantly over the years, and we now know much more about the harms opioids can cause, especially regarding the risk of addiction and dependence.” 

Dr Smartt goes on to highlight the importance of tools like SafeScript in addressing these concerns. “Fortunately, we now have SafeScript, which provides alerts when a drug of dependence is prescribed. But some doctors aren’t using it regularly or may not have it incorporated into their practice software,” she says. “We do look closely at SafeScript during a performance assessment.” 

The team then assesses whether the issue is isolated or part of a broader pattern. “We need to review the doctor’s records to determine whether this is a one-off issue or an ongoing problem. It’s often not a deliberate disregard for patient safety, but more about a lack of understanding of the potential harms and risks involved.” 

Dr Smartt explains that in these cases, action is taken to help the doctor improve while still prioritising patient safety. “If necessary, we may recommend removing their prescribing rights and recommend further training on managing chronic pain or the safe use of these medications,” she says. “This is all done with the aim of protecting the public.” 

Even if a complaint stems from a single incident, Dr Smartt notes, the goal is to prevent further issues. “It might only be one complaint, but if we see a pattern of unsafe prescribing, we want to eliminate the risk to other patients,” she explains. “Often, when people make complaints, it’s because they don’t want something like that happening to someone else.” 

“One of the best things a doctor can do when they face a complaint is to reflect on their practice,” Dr Smartt says. “No one is perfect, and everyone makes mistakes. What matters is whether you’re willing to learn and grow from those experiences. If a doctor can show they’ve taken steps to understand what went wrong and are actively working to improve, it can make a huge difference in how the Council handles the case. Reflection is also key to avoiding further issues down the line, particularly if it leads to positive changes in how they practice.” 

“It’s important to note here that when we say satisfactory, we mean against their background, training and experience. If the performance assessment reveals that a doctor’s practice isn’t satisfactory, we may impose certain conditions to help them improve,” Dr Smartt explains. “This could mean limiting their prescribing rights, putting them under supervision, or requiring additional training. It’s not about being punitive but about ensuring that they’re equipped with the tools and knowledge they need to do their job safely. The goal is to protect the public and make sure that doctors continue to provide the best care they can.” 

“First of all, make sure your medical records meet the legislative standard,” Dr Smartt advises. 

“Secondly, stay up to date with the latest guidelines and best practices. Medicine changes all the time, and even experienced doctors can benefit from regularly reviewing new evidence, like the electronic therapeutic guidelinesopen_in_new.” 

“And lastly, engage in continuing professional development (CPD). It’s not just about improving in the areas you’re already good at but also filling in the gaps in your knowledge. That’s what keeps your practice fresh and safe.” 

“For me, the most rewarding part is knowing that we’re helping doctors get back on track and ensuring that patients are safe,” Dr Smartt says. “It’s a privilege and it’s not always easy, but it’s incredibly fulfilling.” 

If you would like more information on the performance pathway, you can find it on our website.