2022.1 Case 8
Handling patient complaints is a crucial aspect of medical practice, especially in general practice settings. It involves a structured and professional approach that respects patient rights and ensures the maintenance of trust in the healthcare system. The approach to handling complaints typically includes the following steps:
- Acknowledgment of the Right to Complain:
- Recognize and respect the patient’s right to express dissatisfaction about their care.
- This is foundational in maintaining a transparent and trusting relationship between doctors and patients.
- Prompt and Open Response:
- When a complaint is received, it should be addressed promptly.
- The response should be open and constructive, offering an explanation and, if appropriate, an apology.
- Promptly addressing complaints can often alleviate further distress or misunderstanding.
- Effective Communication:
- Communicate clearly and empathetically with the patient.
- Listening to the patient’s concerns attentively and respectfully is essential.
- This helps in understanding the exact nature of the complaint and addressing it effectively.
- Investigation and Reflection:
- Thoroughly investigate the complaint to understand all aspects of the issue.
- Reflecting on the complaint is important for learning and improving medical practice.
- This involves reviewing the circumstances, what went wrong, and the implications for patient care.
- Learning and Improvement:
- Use the complaint as an opportunity to improve.
- This could involve changes in clinical practice, staff training, patient communication strategies, or practice policies.
- Resolution and Follow-Up:
- Aim to resolve the complaint in a manner that is satisfactory to both the patient and the medical practice.
- This could involve corrective actions, changes in procedures, or other measures to prevent recurrence of similar issues.
- Follow-up with the patient to ensure that their concerns have been adequately addressed.
- Documentation and Confidentiality:
- Keep detailed records of the complaint, the investigation process, and the resolution.
- This should be done while maintaining confidentiality and privacy as required by professional guidelines and laws.
- Supporting Staff and Colleagues:
- In cases where complaints involve specific staff members or colleagues, support should be provided to them throughout the process.
- It’s important to ensure a fair and unbiased approach while dealing with internal aspects of the complaint.
- Compliance with Policies and Legal Requirements:
- Ensure that handling of complaints is in compliance with the relevant healthcare policies, procedures, and legal requirements.
- This includes being aware of any mandatory reporting obligations.
- Respecting Patient Care:
- Ensure that the complaint process does not adversely affect the patient’s ongoing care.
- If necessary, consider involving another practitioner to maintain objectivity and continuity of care.
In Australia, patients have several formal avenues to make complaints against doctors. These avenues are designed to ensure patient safety, uphold professional standards, and address any concerns or grievances related to medical care. Here are the key options:
- National Boards and the Australian Health Practitioner Regulation Agency (AHPRA):
- AHPRA works in partnership with 15 National Health Practitioner Boards, including the Medical Board of Australia, to manage complaints or concerns regarding health practitioners.
- Complaints can be made online via the AHPRA website or through postal mail.
- These complaints can be about professional conduct, health, performance, or registration of the practitioner.
- Health Complaints Entities in Each State and Territory:
- Each Australian state and territory has its own health complaints entity. Examples include:
- Health Complaints Commissioner in Victoria.
- Health and Community Services Complaints Commissioner in South Australia.
- Health Ombudsman in Queensland.
- These entities handle complaints about health services provided by medical practitioners and other health providers.
- Each Australian state and territory has its own health complaints entity. Examples include:
- Hospitals or Healthcare Institutions:
- If the medical practitioner is associated with a specific hospital or healthcare institution, a complaint can be lodged directly with that facility’s complaints department.
- Most hospitals have a patient liaison or a patient advocate office that handles complaints and mediates between the patient and the healthcare providers.
- Medicare or Private Health Insurers:
- For issues related to billing or insurance claims, complaints can be made to Medicare or the relevant private health insurer.
- Ombudsman:
- If a complaint regarding a public service is not resolved satisfactorily through the usual channels, patients can contact the Commonwealth Ombudsman or the respective state/territory Ombudsman.
- Legal Action:
- In cases where there is a potential for malpractice or negligence, seeking legal advice can be an option.
- Law firms specializing in medical law can provide advice on the feasibility and process of pursuing legal action.
Important Considerations
- Confidentiality: Complaints can usually be made confidentially, and the privacy of the complainant is protected.
- Documentation: It’s important to provide detailed information and any relevant documentation to support the complaint.
- Response Times: Response times can vary depending on the complexity of the complaint and the agency handling it.
- Resolution: The resolution process may involve mediation, investigation, disciplinary actions against the practitioner, or sometimes a referral to a tribunal for serious cases.
Patients are encouraged to first discuss their concerns directly with the healthcare provider or the local health service where the care was received, as many issues can be resolved at this level. However, if this is not satisfactory or possible, the above avenues are available for more formal complaints.