Complaints by patients and claims for compensation are, unfortunately, common. Understandably, doctors take pride in their skills, knowledge and expertise. Complaints can have an adverse impact on a doctor’s reputation, regardless of whether there is merit to them. There are steps to limit the potential risk of prejudice to a doctor’s practice.
Checklist
Internal Complaints Handling systems
- The Hospital Authority and private hospitals have well-established complaints handling systems and doctors should ensure they fully understand them and follow the process.
- Individual private practitioners/clinics should ensure there is a system with clear directions and training to all staff, especially for support staff who are often the first point of call. First impressions count and the manner in which a complaint is first received has a great impact on the outcome.
Regular staff training and reviews
- If a doctor is part of a hospital or clinic, they should regularly attend training on the complaints process to keep up-to-date with any changes.
- For individual private practitioners/partnerships, responsibility for the doctor’s employees’ training rests with the doctor. Protocols should be followed in recording and managing complaints.
Manage a complaint promptly and effectively
- Take control of the complaint. Listen and act immediately, even if in the first instance simply acknowledging and recording the complaint and giving a time-frame to respond.
- Any attempts to dismiss the complaint (without looking into it carefully and responding appropriately) is likely to exacerbate the complaint. This is a trigger for escalation to the Medical Council.
- Adopt a facilitative role.
Upon notice of a complaint, you should:
- Actively listen to the complaint without interruption and ensure the complaint is accurately documented.
- Pause and process. Review the complaint record and medical records again.
- Summarise and address the concerns and discuss what is requested.
- Let the patient know you will consider, review the case and agree on a reasonable time-frame to discuss/meet again.
- Report the matter to your indemnity provider or insurer for assistance (at the first instance or after gathering the facts).
- Plan ahead. Be aware of the real risk of escalation of the complaint to the Medical Council and potentially lengthy investigations into allegations of professional misconduct.
- Preserve and keep secure the original medical records. Make copies of medical records/reports provided to patients and document when disclosed.
- Prepare a detailed report on the patient, the complaint and your management. Document all relevant communications with the patient/complainant as soon as possible after the incident/complaint.
- Report any written requests from the Medical Council for copy medical records (Requests) or notices of meetings of the Medical Council’s Preliminary Investigation Committee (PIC Notices) received to your indemnity provider or insurer immediately for assistance.
- There is no time limit for a complaint to be made to the Medical Council. Requests and PIC Notices are usually issued many years after complaints are received.
Comment
Remember, we all make mistakes and can make improvements. Facilitate patients/complainants and inform them of the complaints handling procedures and time frame for investigation and response. Listen to and address the patient’s concerns, adopting a patient-centred approach.
Often complaints result from misunderstandings, but genuine mistakes are made and cannot be prevented entirely. The key is to acknowledge and learn from mistakes and reduce the risks of recurrence and escalation with the above checklist. Keep up to date with the latest practices through continuous education. Work with your legal advisers. Full knowledge and understanding of the issues will determine how a complaint can best be managed to achieve the best outcome for all.
Read more items in Hong Kong Medical Law Brief - October 2019
