How to deal with a complaint

An apology and sympathy can go a long way to resolving a grievance, explains the MDDUS's medico-legal adviser Dr Jim Rodger.

As a doctor, it is almost inevitable that you will have a complaint made about you at some point in your career. Doctors work with patients who are ill, vulnerable and who can, in some circumstances, be understandably irrational.

Illness can change a patient's personality. Their discomfort and vulnerability often manifest as anger at their circumstances and aggression toward those who care for them.

Respond to the complaint
Doctors must know how to deal with complaints. However hard it is, try not to regard complaints as personal attacks on your competence or clinical manner.

Never be tempted to ignore a complaint, even though an expression of a patient's unhappiness may be hurtful.

Long delays in responding simply fuel the grievance and lead to more heated correspondence. Doctors have a professional obligation to respond to complaints in a timely manner; they are also obliged to do so by their terms of service.

A substantive response should be made within 10 days from a GP (or 20 days from a trust).

A sympathetic approach
Patients need a sympathetic hearing, even if this may seem difficult under the circumstances. Listening sympathetically often solves the problem.

The attitude of doctors and staff to patients is the most common complaint patients and their carers make. Recognising this will lead to better handling of the complaint.

Reinforcing the perception of an uncaring or unsympathetic attitude by responding to a complaint in a careless or dismissive way is a recipe for disaster. Even if you feel that a complaint is unfounded or even malicious, you must still treat it seriously.

Remind yourself, if necessary, of the prevailing imbalance of power and status that exists between you and your patient.

The experience of the Medical and Dental Defence Union of Scotland (MDDUS) is that it is extremely rare for a complaint to be malicious, but there may be little genuine basis for dissatisfaction.

A doctor's job is to be empathetic and, if necessary, sympathetic in clinical matters, and equally so in complaint handling. Complaints can be an opportunity, rather than a threat.

A good response
Responses should be swift, detailed and give a factual account, from the doctor's point of view, of the situation that gave rise to the complaint.

The response should be tailored to the circumstances of each specific complaint, but limited to those circumstances. A close, careful read through of the complaint and any relevant clinical records will be required.

Your medical defence organisation may assist in checking drafts of responses - the MDDUS does - but cannot help formulate this initial reply. You need ownership. It is the responsibility of you and your practice.

A good response, particularly if it includes an apology, will normally end matters. If not, a patient or carer can ask for an independent review of the way the complaint was dealt with.

In these circumstances, your defence organisation should give you all the assistance, advice and support necessary to help you deal with these investigations, which are by their nature rarer but often more complex.

Making apologies
Apologies can go a long way to assuage a patient or carer's grievance. An apology is not an admission of fault but an acceptance of what has happened.

Apologies can also be made for putting the patient in a situation that gave them cause for complaint. The MDDUS encourages their use in this way, although we would never recommend a grovelling apology if you have not done anything wrong.

Feedback
Complaints offer practices and individual GPs an insight into how they and their working arrangements appear to patients. A complaint is consumer feedback that can and should be used to improve the quality of service provided to patients. This may even help to prevent further complaints.

  • Dr Rodger is medico-legal adviser and head of professional services at the MDDUS

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