Many doctors, at some stage in their career, will receive a complaint from the Health Professions Council of South Africa (HPCSA). A patient may be dissatisfied with the level of care they have received for a near infinite number of reasons. Whatever the complaint, these practical tips explain what you should do next, says Dr Graham Howarth, Head of Medical Services in Africa at the Medical Protection Society.
Receiving a complaint can be stressful. It can knock your confidence, but it is important to remember that many doctors do receive a complaint at some stage in their career. It is not necessarily an indication of poor clinical performance, on the contrary more often than not there is some sort of miscommunication.
Handling a complaint requires time and commitment during a period when you might be feeling at your most vulnerable. Getting it right can pay huge dividends. It also marks you out as a true professional. Whatever you do, don’t fire off an intemperate response however ridiculous you may think the complaint is. Equally important don’t ignore the correspondence.
Handling a complaint requires time and commitment during a period when you might be feeling at your most vulnerable. Getting it right can pay huge dividends
The first thing to do is keep calm – though easier said than done, try not to panic. Read the HPCSA’s letter again carefully – you won’t have digested all of its content during your initial reading. It’s important to understand exactly what the patient is complaining about. Is it your attitude, your diagnosis, a clinical error or something else?
Once you understand what the complaint is, you need to work out how to respond to it. You should contact MPS as soon as possible. MPS medicolegal advisers are able to provide you with support. They can help in formulating a response and submit it on your behalf.
MPS can provide specific assistance and support for your individual complaint. In general, when composing your letter you should take into account the following:
- The purpose of the response should be to try and resolve the complaint, not to perpetuate correspondence. Being courteous, objective and professional helps.
- Identify the concerns that have been raised and respond to all parts of the complaint. It is often helpful to set out an account of what took place, including background information. Do not lose sight of the issues.
- Establish the facts before attempting to provide a full response to a complaint.
- Take time to present a measured, considered and considerate response, bearing in mind the timescales. Try to review your records before you draft your letter.
- Be aware of patient confidentiality. Not all complaints are made by the patient personally. Where a complaint is made about the service provided to a patient who has the capacity to give a valid consent, that patient’s confidence must be respected.
- Try to be sympathetic and understanding. Offer condolences if these are due. Do not be afraid of apologising if an error has been made.
- Avoid blaming or judging others.
- Avoid jargon – use plain language.
- The response should be typed, so that it is clearly legible.
What not to do
Community Service Officer Dr L was working in a rural area. He received a letter from the HPCSA regarding a complaint from a patient, Ms K. Dr L was infuriated. The complaint related to a minor clinical oversight which had had no clinical effect on Ms K. Dr L felt that the complainant was suggesting he had completely missed an obvious diagnosis and was not competent to practise as a result.
A well-thought-out letter of response is far more likely to be successful than a knee jerk response, which will only serve to make matters worse
He felt that the complaint was defamatory and immediately wrote a curt letter of response, rebutting the allegations and outlining his concerns that they had been raised in the first place. He then contacted MPS and informed the medicolegal adviser that although he had received a spurious complaint, he had dealt with it. Dr L also requested assistance in suing Ms K for defamation.
Learning points
- However spurious or frivolous a complaint may seem, all complaints should be investigated and responded to appropriately. If a patient makes a complaint, the HPCSA is duty-bound to investigate it.
- If you are the subject of a complaint, take a moment to stop and think before responding. A well-thought-out letter of response is far more likely to be successful than an intemperate one, which will only serve to make matters worse.
- It would have been preferable if Dr L contacted MPS before responding to the complaint, as MPS would have written a letter of response on Dr L’s behalf, through one of our panel law firms. MPS is unlikely to assist members in suing for defamation in response to a complaint made by a patient.
Visit page 63 of the April edition of Medical Chronicle to read the article in full >>