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As early career doctors, how we manage complaints matters

As you start out in medicine, you will need to learn how to manage a patient complaint or a complaint from a regulatory body.

Dr Lauren Feitelson, Doctor in Training Medical Adviser, Avant

Monday, 27 May 2024

Managing patient expectations and feedback is a part of your role as an early career doctor. While most patients will appreciate the care you provide, sometimes a clinical encounter doesn’t go to plan, and you can sense their disappointment and frustration. When this happens, it helps to proactively communicate with the patient to understand and address their concerns.

Knowing how to manage situations where a patient complains can make a positive difference – not just to the patient outcome but also to how you cope with what can be a stressful experience. Additionally, reflecting on their complaint allows you to adjust your clinical practice, contribute to systemic changes, and hone your empathy and humility.

Know the complaints process in your workplace

Your workplace should have a process for receiving positive and negative feedback from patients – following this process may give you the opportunity for quality improvement and professional development.

When you are the first point of contact

If a patient complains to you directly, encourage them to tell you what has happened in their own words – and listen. Try to ascertain the patient’s concerns. Is it because they want access to test results, more detailed explanations, or feel they haven’t received the care they need? It’s important to acknowledge their complaint and feelings, because generally a patient’s main requirement is to be heard and understood. You can apologise for your actions (if relevant), for any unwanted outcomes or for the patient’s discontent.

If you receive a complaint in writing, or if it is verbal but too complex to be dealt with immediately, acknowledge the complaint has been received and let the patient know you are looking into it and will respond by a certain date. Try to ensure the patient is contacted by this date, even if only to say you don’t yet have an answer.

Hospital-based early career doctors should be supported by senior colleagues

If you are a hospital-based doctor, ensure the consultant or your training supervisor is aware of the complaint. Consider whether you are the best person to deal with it – it may be appropriate for a senior colleague to respond. Avant can assist you with these decisions or with your response.

Depending on the nature of the complaint, a meeting to discuss the patient’s concerns can be helpful. This may include all members of the team, including the consultant, the nurse unit manager and other appropriate personnel. While you may be asked to make the arrangements for this meeting, you should never be expected to attend the meeting alone and without the support of your senior colleagues or at least someone else present.

GP registrars

As a GP registrar any complaint will probably be received via your practice manager. Speak to your supervisor who can help formulate a response for the practice manager and offer education around the incident. Avant can assist you writing responses to complaints received at your workplace.

Providing a satisfactory response to a complaint, so the patient feels heard and understood, may prevent them from making a formal complaint to the regulator.

Meeting with a patient to discuss a concern or complaint

Whether you are a GP registrar or hospital-based, a meeting with a patient is an important step to resolve concerns. Arrange an interpreter if language is a barrier. Find a quiet and private room for the conversation and allow plenty of time.

During this meeting, provide information about what has happened and consider the factors that led to the complaint. Check the patient’s understanding and answer their questions using terminology they can easily understand. After the meeting, provide a summary of what has been covered and achieved, and establish if the patient is satisfied with the response.

This is similar to the open disclosure process for adverse events or near misses, which is mandatory in hospitals and some GP practices. Ensure you are familiar with your workplace’s policies and procedures on open disclosure. If you work in Victoria, be familiar with the requirements of the statutory duty of candour that applies when a patient has suffered a serious adverse patient safety event.

Regulatory complaints are rare for early career doctors

A patient may also complain via the medical regulator, with the process for this varying state by state. At this stage of your career, it would be rare for you to be the only subject of a formal complaint to the regulator. Of all Avant early career doctor members in FY21, only three out of every 1,000 interns and 22 out of every 1,000 hospital-based registrars received a complaint via a regulatory body. And 97% of these were dismissed with no further action.

In the hospital setting, you may be named in a formal complaint as one of several doctors involved in the patient’s treatment. Even if you aren’t directly named but were involved in a patient’s treatment, you may be asked by the hospital to provide a response to the issues raised in the patient’s complaint.

As an Avant member, you are required under your insurance policy to notify us in writing as soon as practicable when you become aware of any facts or circumstances that could lead to a claim under the policy.

Avant is on hand to support you

If you receive a complaint from the medical regulator, make sure to contact us prior to any patient contact or formulating a response. The team assisting you will include a claims manager and, if required, a medical adviser and lawyer. We can provide information about the regulatory complaints process and connect you with support to help you through what we understand can be a stressful situation. Do not speak about the complaint with the patient or person who has made the complaint directly, as this could be interpreted as interfering with the complaint process.

Additional resources

Find out more about how Avant can support you as an intern, RMO and doctor in training, both through your medical career and your life outside medicine.

Related article: I wish to make a complaint - a personal reflection

More information

For medico-legal advice, please contact us on nca@avant.org.au or call 1800 128 268, 24/7 in emergencies.

Disclaimers

This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published.

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