COMMENTARY

Malpractice Dangers in Patient Complaints

Lee J. Johnson, Esq

Disclosures

July 19, 2010

In This Article

Best Ways to Deal With Complaints

To ensure that patient complaints don't take on a life of their own, here are some actions you can take:

Develop a culture of patient safety; meaning that staff sees that keeping the patients well treated and happy is the goal. Let staff know that patient complaints are inevitable, and train staff on how to address them. Have staff meetings, where problems and complaints can be discussed.

Consider other ways to uncover patient complaints, such as a suggestion box and patient-satisfaction surveys.

Create a procedure for handling patient complaints. The procedure should be a verbal and nonwritten policy. Just having a process for handling patient complaints may create a long-term effect of reducing malpractice risks. Most patients are willing to forgive occasional annoyances or disappointments if they perceive that you and your office staff care about their needs and are trying to satisfy them.

Discuss the complaint with the patient in person. If the patient complains by letter, phone, e-mail, or text message, invite him to come in for a free consultation with you. Reply promptly with an expression of your interest in the patient's satisfaction.

Specific Types of Complaints

Nonclinical complaints. Many patient complaints have to do with office procedures, such as long waiting times, failure to return telephone calls, attitude of staff, and billing issues. These types of complaints can often be handled by staff (unless the complaint has to do with specific staff members). If you have a large group practice, you can appoint a Risk Manager. Or you can delegate the authority to your Office Manager to handle these issues.

Sometimes a review of complaints will point out patterns of problems. Or your staff may spot an ongoing problem that needs to be remedied. If your staff, your partners, or even you yourself are having trouble dealing with patients, you may want to consider counseling for stress management or communications training.

Hospital complaints. The most common complaint in the hospital setting is that the doctor doesn't see the patient often enough. That you can remedy. Try to have a hospitalized patient seen every day by either yourself or your colleague. Other complaints, such as the patient doesn't like the food or the hospitalist doctor, may not be within your control. Make appropriate contacts and let the patient know what you plan to do or have done.

Clinical complaints. If the patient has clinical complaints, you should address it yourself. You must become personally involved in the more serious issues, particularly those related to quality-of-care concerns.

Listen. Show sincere interest. Listen to the patient's story, ask questions, and make sure you understand her problems.

Express sympathy for the patient's inconvenience or disappointments. A patient who feels she isn't making much progress with treatment is terribly frustrated. Acknowledge that feeling.

Show a strong commitment to resolving the problem. Ask the patient how she thinks the problem should be dealt with, thank her for bringing it to your attention, and follow up. If the patient complains about waiting too long, ask her whether she would like to be the first patient of the day or whether she could call your staff first before leaving home. Thank her, and put a note in the chart for staff to notify patient of any future delays.

If the patient has a bad result, invite the patient to have an office visit. Family members may be included if the patient consents. Explain that there are risks to every procedure and that a bad outcome is not necessarily the result of any human failures.

If a patient is really upset with his care, you may want to take measures to mollify. You can consider waiving the bill, as long as you make it clear that there is no problem and that you just want your patients to be happy. You may also offer to refer the patient to another physician in your practice or community.

If the patient threatens a lawsuit, you should notify your insurer. Notice is a requirement of all policies. The insurer may authorize a quick settlement.

Complaints about other doctors. Do not go there. If you indicate that you think another physician's care is anything less than optimal, you may alienate that physician. You may also be named in a lawsuit if the patient sues in an attempt to get your free expert testimony.

If you've found some resultant damage that needs correction, such as a foreign body left after surgery, you'll have to inform the patient as part of your diagnosis, treatment plan, and informed-consent procedure. But stick to the facts without blaming or casting aspersions on the other doctor.

Documentation

If you have a conversation with the patient, document it in the patient's chart. Date the note, as it may later become evidence of when the statue of limitations was started. If you have a conversation with your insurer or lawyer, put that in a separate file.

Seek out and uncover any patient complaint or dissatisfaction so you can address it. The first time you hear about a problem should not be with a formal legal complaint.

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