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  • Dealing with a direct patient complaint

    It is a confronting experience to receive a complaint. One study found that 95% of doctors experienced stress during the complaints process and most stress occurred on receiving the complaint. 50% reported that the stress interfered with their personal and professional lives[1].

    Complaints may come to you in many ways and in many forms. Here we outline ways to dealt with complaints that have come directly to you or your practice from a patient. While the temptation may be to deny the issue and/or blame the patient, it is worth putting in the effort to address patient complaints early, and minimise the impact of the complaint on you and your staff. This benefits you, your staff and your patients.

    Why do patients complain?

    Patients usually complain because something has gone wrong but they may also complain because of unmet expectations or because there has been a breakdown in communication. In our experience common complaints include:

    • Dissatisfaction with the experience at a practice – for example, the patient was kept waiting too long without explanation or the staff were rude.
    • Privacy breaches – releasing information to others, or not giving patients access to information
    • Complaints about personal or professional behaviour of doctors and/or their staff
    • Communication issues
    • Concern over clinical matters such as an unexpected or adverse outcome or result
    • Unexpected fees or out of pocket expenses.

    How do I respond to a patient complaint?

    How you deal with a patient’s complaint may have an influence on whether the matter goes any further (eg to the Medical Board, AHPRA, other complaints handling body or to the patient’s lawyer). In our experience, it is better to deal with a complaint locally, rather than have it escalate to a regulator or lawyer.

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    Reminder from avant-learning-centre

    Factsheet Dealing with patient complaints

    Have a complaints handling protocol?

    You should have a protocol at your practice for dealing with direct patient complaints. We recommend that you designate a staff member as the single point of contact for complaints about your practice. If patients perceive that their complaint is being taken seriously and is being handled by someone with sufficient authority and sensitivity to address and resolve their concerns, they are generally more likely to accept the outcome.

    You should seek to deal with complaints about your clinical care yourself, but complaints about the practice or administrative issues could be dealt with by your practice manager.

    Do not ignore complaints. Seek to deal with complaints as quickly as possible with an emphasis on resolving the patient’s concerns.

    Some patients will make complaints verbally but for substantial complaints, it is preferable to ask the patient to put the complaint in writing. This will better allow you to clarify the scope of the complaint, and it can be used as an agenda for any meeting with the patient.

    If you receive a complaint in writing, make initial contact by phone to acknowledge receipt.

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    Reminder from Avant risk iQ

    Watch our webinar Predicting medico-legal risk: latest research and its application to practice" with Maree Bismark.

    Learn more about the privacy reforms with Avant's privacy reforms guide

    Resolving the complaint

    One aim of resolving the complaint early is to try to preserve your therapeutic relationship with the patient. This involves listening to the patient’s concerns and showing empathy, even if you think the complaint is trivial or you do not accept the basis of the complaint.

    Steps to take to respond to a complaint:

    • Gather the facts: review the medical notes, copies of reports, records of phone calls, discussions with relevant staff, check local protocols and check what happened on that day.
    • If referral or follow up is required, work out a management plan for the patient.
    • Consider whether you need specific advice from Avant about the complaint and/or plan of management before you respond.
    • Where appropriate suggest a face to face meeting to discuss the patient’s concerns. Encourage the patient to bring a friend or partner to accompany them if they wish. Suggest an interpreter if language is a barrier. Allow plenty of time. Find a quiet, private room for the conversation.
    • Provide information. Most people who complain wish to obtain information about what happened and what it means for them. Provide them with this information.
    • Consider the factors that led to the complaint – are there changes that can be made to prevent a recurrence? If so, tell the patient as they will wish to see that you take the complaint seriously and that it will make a difference.
    • Keep the patient informed. If there will be delays while you seek out facts or will not be available, say so, as uncertainty or ‘no response’ only adds to the grievance
    • If the patient has had an unexpected or adverse outcome, acknowledge the patient’s distress and, if appropriate, validate it. If you are also upset about an outcome, tell the patient ‘this is not the outcome either of us wanted or anticipated’. There is nothing wrong with demonstrating empathy or apologising.

    Sometimes, despite your best efforts, the therapeutic relationship will have broken down to such an extent that you feel the relationship can no longer be sustained. There are ways of managing this – seek advice from Avant’s Medico-legal advisory service to find out more.

    Regardless of the outcome there is an opportunity for improvement – encourage a culture of continuous improvement and be open to change.

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    Reminder from Avant risk iQ

    Factsheet Open disclosure – How to say sorry

    Cautionary Tale

    Tips

     

    Dealing with a direct patient complaint

    • Where possible (and appropriate) make personal contact by phone when you receive the complaint
    • Preferably ask for the complaint in writing
    • Before replying in writing, ring the patient and clarify the concerns
    • Deal promptly with the complaint
    • If there is to be a delay in responding, let the patient know and give a time frame
    • Show empathy to the patient even if you do not accept the basis of the complaint
    • Let the patient know what has been done to improve systems and processes at your practice as a result of their complaint
     

    Cautionary Tale

    Tips

     

    Preventing complaints

    • Ensure staff understand why good complaints handling is important.
    • Every complaint should be a learning opportunity – use the complaints to recognise possible problems with your systems or emerging expectations of your clients and customers.
    • With every complaint ask: is there more training of staff required? How can we prevent a recurrence? What can we do to improve our processes?