When patients complain

A Having a clear policy for managing patient complaints should definitely help your group avoid malpractice litigation and also improve patient relations. In fact, plaintiffs' attorneys say the primary reason that clients approach them about suing a doctor is that they couldn't get a satisfactory response to their complaints or questions about their care.

With complaints about medical treatment, first ask your malpractice carrier for legal advice before responding. In such cases, the doctor who treated the patient-not an aide-should review and explain the rationale for the treatment, why complications may have occurred, how they will be managed, and the patient's prognosis.

Help them understand that unexpected complications and poor results can occur without anyone being negligent. If they raise the issue of monetary compensation, discuss that option with your liability carrier before responding. Your insurer may authorize reimbursement for medical or other expenses, such as additional tests, or treatment by another doctor.

Don't discuss a serious complaint with family members unless the patient has authorized you to do so. And don't discuss it with the patient's attorney-or respond to a letter from him-without your carrier's approval. Remember, what you say or write to a plaintiff's attorney is not privileged, and could be used in court.

With serious complaints, document the details of any discussions with the patient in the patient's chart, and document your conversations with your insurer in a separate, confidential file. In many states, the statute of limitations for filing a malpractice suit begins to run when the patient first discovers the injury. Your notes might help determine when the patient became aware of the injury-particularly if he or she mentions possible legal action.

Whatever the nature of the complaint, try to conduct the discussion calmly and professionally. If your efforts to keep the discussion cordial fail, try to defer it until tempers have cooled.

According to insurers, malpractice claims are often motivated by patient complaints involving nonclinical factors: such as waiting too long at a scheduled appointment. Trained staff should be able to handle such problems. But you should be the one to deal with complaints involving your "bedside manner," such as spending too little time with patients or not answering their questions. You might consider waiving or reducing fees to resolve such minor complaints.

Periodically, review all the complaints your office receives. You may see patterns that suggest the need for changes in office policies or billing practices. Or you may find that certain physicians or staff members need counseling about their attitude, telephone etiquette, or general patient relations.

The author is a risk management and loss prevention consultant in Cloverdale, CA. He can be reached by e-mail at lossprevention@earthlink.net
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This department answers common professional liability questions. It isn’t intended to provide specific legal advice. If you have a question, please submit it to Malpractice Consult, Medical Economics, 5 Paragon Drive, Montvale, NJ 07645-1742. You may also fax your question to 973-847-5390 or e-mail it to memalp@advanstar.com
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