Complaints against medical practitioners in Hong Kong: five fundamental rules for managing the complaints process

Rule 1 - Familiarise yourself first with the internal complaints process and your regulatory bodies’ disciplinary processes.

• Before a formal complaint is escalated to the Medical Council of Hong Kong, Nursing Council or Consumer Council and so on, promptly deal with it first internally, within your clinic or hospital according to the system.

1. Acknowledge the complaint. Inform and direct the complainant to the complaints process and be prepared to cooperate with that process and professional advisors.
2. Our Hong Kong Medical Law Brief issued in October 2019 provided a Checklist to serve as a practical guide on what should be done to manage complaints from the outset to reduce the risk of escalation in the first place.

• Refresh your memory and keep up to date with disciplinary investigations processes and proceedings.

1. Time spent now will not be wasted. It will assist in preventing, managing and the proper handling of complaints at various stages.
2. You will work better and more efficiently with your indemnity provider, insurer and legal advisor to respond to the complaints with this background knowledge.

Rule 2 - Follow the steps in the complaints process and consider advice and options.

• Try to take a step back and objectively assess the incident and subject(s) of the complaint.

1. Start with the facts and prepare an account of the incident, be it a medical consultation and advice, surgery or follow-up treatment.
2. Separate the emotions from the incident. Is it truly and solely an unjustified challenge to your advice and treatment options?

• Consider all the evidence before responding and reporting to your supervisor (if any), indemnity provider, insurer and legal advisor.

1. Gather – the medical records, reports and information on the patient and incident.
2. Record – document all relevant communications with dates.
3. Clarify – review current evidence, test recollection and obtain clarification from other people involved promptly after the complaint/adverse incident.
4. Preserve – all of the above on paper or save electronically on the practice’s system.

• Seek professional help in the process. Listen carefully to the options advised for handling the complaint and the potential implications on your practice. Work with your legal advisor.

Rule 3 - Never feel alone or afraid to share.

• Accept that complaints and adverse incidents will be part of your daily practice.
• Seek help - many of your peers and seniors will have experience of this.
• Legal advisors specialising in medical malpractice handle and advise on such complaints on a daily

1. All communications should be kept confidential and are protected by legal professional privilege.
2. Be frank and share all the relevant information in relation to the complaint, not just the information which supports your defence.
3. Your legal advisor is best placed to provide advice and generate viable options for discussion, when equipped with all the information. This is the case even when the so-called “facts” are in dispute. This is a common scenario.

Rule 4 - Your wellbeing is our paramount concern.

• Take control over matters that you can control. For example your health, diet and well-being.
• Your stamina and well-being must be maintained in the process, which could take months or even years to resolve. It is often a marathon, not a sprint.
• Delegate the tasks to lighten your burden, if possible. Can others assist in reviewing and providing the necessary information? Get help from experienced staff or colleagues to coordinate the transfer of data or information and so on.
• Take time out, but make time for your legal advisor. You will be in close contact - in particular at the initial stage of a complaint and towards the end, be it a disciplinary inquiry or discussion on settlement terms.

Rule 5 - Be prepared for change – for the better.

• Take the complaints process as an opportunity to review and improve your daily practice and clinic/hospital system.
• The move to a “patient-centred” approach to medical practice and negligence claims has long been apparent. Be prepared for positive changes and to be updated with the current medico-legal landscape and society.
• Remember you are a provider of a professional service. There are expected standards in law from those who receive the service. Very often the mismatch in expectations leads to complaints and claims. Try to narrow down the gap.

A better understanding from the patients’ perspective, coupled with legal and risk management advice from advisors, leads to better communications and reduction of and/or better handling of complaints to prevent escalation.  A “win-win” outcome for all. We speak from experience.

Read more items in Hong Kong Medical Law Brief - Spring 2020 edition