Steve Ainsworth advises that dealing with patients' complaints is a stressful experience

Once upon a happy time doctors buried their mistakes." That's one fairy tale at least that's not true. Believe me, I know. In one capacity or another I've spent the best part of 30 years listening to patients complaining about their experiences of the medical profession and attending hearings at which accused doctors have, in varying degrees of defiance or dejection, been asked to account for their acts and omissions.

Medical students will just have to face up to it, being a doctor is a dangerous profession. When I was young I often heard doctors moan about something they called "double jeopardy." What they meant was that not only did they risk being sued for their failings but they also faced the prospect of being hauled before the General Medical Council.

When I knew a little more I realised that it was actually much worse than mere double jeopardy. The police may be brought in, for example over a suspicious death - a risk more likely than ever in this post-Shipman era - and then there are NHS disciplinary hearings.

A complaint made by a patient can be a time consuming and frightening experience. Even a relatively simple case can have a long run. Take a complaint against a general practitioner, for example. General practitioners are supposed to have an in-house complaints procedure so the first stage of a complaint is dealt with inside the practice. That may involve meeting the complainant and writing letters to answer his/her criticisms. If that fails then you move on to an independent review panel convened by the health authority. An IRP can call you to appear before it to enable its members to discover the facts and make recommendations about what to do. And did you think that's the end of it? Then think again. If the health authority doesn't like the IRP's report then it can convene a disciplinary committee, and everything is gone through again - this time with the health authority acting as public prosecutor and with warnings and fines promised for those who are found to be "in breach of their terms of service" (the general practitioner's contract with the NHS).

Even then the terror is not over, as the case may then be referred to the General Medical Council, which might well subject the poor doctor to an even more rigorous hearing. No wonder that at least one general practitioner decided to take his own life rather than face up to the coming ordeal. Every doctor must accept the fact that sooner or later he or she is likely to have to meet with this kind of experience; it simply goes with the territory. All one can do is try to reduce those occasions to a minimum and, when they do occur, face them in a stoical and sensible manner.

How do you minimise your chances of finding yourself in the dock? Well the obvious way is by being a perfect doctor, but there is no such thing as perfection. Nor is perfection expected - an incorrect diagnosis reasonably arrived at is a good defence, but that still doesn't stop a complaint being made. Three things do stop complaints: courtesy, concern, and, lastly, coming in only a poor third, competence. The stories of bereaved relatives extolling the virtues of their general practioner with the words "he's such a wonderful doctor, he even found time to come the funeral" are not entirely apocryphal.

So when, and not if, a complaint gets made how do you minimise its impact? Since the first stage in the complaints procedure is usually an in-house event, either in a hospital or a general practice surgery, many complaints can be resolved at that stage if they are handled sensibly. An hour spent sympathetically, honestly, and, if necessary, apologetically, explaining the issue properly to an aggrieved patient can save days, weeks, and even years of letter writing, meetings, and their accompanying stress and worry.

And if it does go the distance? Well even then don't be unduly alarmed. Thousands of doctors have been there before you and have emerged a little older, a little wiser, and mostly unscathed. There are lots of people to give advice and practical help: professional colleagues will offer support, officers of those bodies running the proceedings will usually be pleased to explain what is going to happen, and the professional defence bodies will also provide an experienced doctor or lawyer to assist and, if allowed, to represent you.

I have seen doctors literally trembling with fear, I have seen them weep with distress and shout with anger and self righteous belligerence, but I've never been convinced that it made much difference to the outcome. The panels investigating complaints consist of lay people and doctors who have considerable experience of sifting out the pertinent facts in each case; they are unlikely to be swayed by mere presentation.

Inevitably, however, not all cases are clear cut, and panel members are only human. Being dignified, compassionate, and contrite if necessary and having all your facts carefully marshalled cannot do you any harm, and a hot-tempered denial is unlikely to do you much good, especially in a case that hinges on one person's word against another.

I recall a case where a doctor had examined a young woman with chest pains and found nothing wrong. An hour later she was dead. It wasn't, however, the forcefulness of the doctor's defence that won the day but the facts: he had very carefully examined the woman not once but twice and, sadly, there simply were no signs of an imminent cardiac arrest that might have been found.

Try not to worry too much and remember that things could be much worse - according to King Hammurabi of Babylon's (1728-1686BC) legal code a doctor who caused a death could have his fingers cut off!