If $\,P\,$ has a multiple root, then it must be a perfect power $\,P(x)=c(x-a)^n\,$.
To prove it, suppose $\,a\,$ is a root of $\,P\,$ with multiplicity $\,k \ge 2\,$, then it is a root with multiplicity $\,k-2\,$ of $\,P''\,$. Since $\,P = Q \cdot P''\,$ it follows that $\,a\,$ must also be a double root of $\,Q\,$ so $\,Q(x) = \lambda(x-a)^2\,$.
Since the problem is invariant to translations of $\,x\,$ and scaling of $\,P(x)\,$, it can be assumed WLOG that $\,P\,$ is monic and $\,a=0$, then:
$\,P(x) = x^k \cdot A(x)\,$ for some monic $\,A\,$ not divisible by $\,x\,$, so $\,A(0) \ne 0\,$;
$\,\lambda = \frac{1}{n(n-1)}\,$ by equating the leading coefficients, so $\,Q(x) = \frac{1}{n(n-1)} x^2\,$.
The equality $\,P = Q \cdot P''\,$ then becomes:
:
$$
\require{cancel}
\begin{align}
x^k \cdot A &= \frac{1}{n(n-1)} \,x^2 \cdot \big(k(k-1) x^{k-2} \cdot A + 2\,kx^{k-1} \cdot A' + x^k \cdot A''\big)
\\ \iff\quad A &= \frac{1}{n(n-1)}\, \big(k(k-1) \cdot A + 2\,kx \cdot A' + x^2 \cdot A''\big)
\end{align}
$$
Setting $\,x=0\,$ gives $\,A(0) = \frac{k(k-1)}{n(n-1)}A(0)\,$, and $\,A(0) \ne 0\,$ implies $\,k=n\,$, which concludes the proof.