Quick Guide
- Having a system in place to manage complaints can ensure that they are handled appropriately and in a timely way.
- Acknowledging a patient’s concerns and responding in a caring way has the potential to deescalate the complaint.
- Consider any options for improvement to your practice and let the patient know what has been done to prevent the issue
that caused the complaint happening again.
Receiving a complaint can be a confronting experience.
Complaints often occur because a patient’s expectations were
not met in some way. How a doctor or practice handles a
complaint initially can assist in deescalating the complaint and
end in a better outcome for all involved.
All patient feedback, including complaints, can be used to
improve the quality of the healthcare that you and your practice
provide. Responding to complaints demonstrates that you value
your patient’s opinions and needs, and this can contribute to a
more positive healthcare experience for the patient.
You are required under your indemnity or practice insurance
policy to notify Avant of any matter you become aware of that
could lead to a claim, investigation or complaint.
Why do patients complain?
The basis of many patient complaints is miscommunication.
Patients may complain if something goes wrong, but more
specifically if the outcome does not meet their expectations.
They are less likely to complain about a sub-optimal outcome
that they were warned of and knew was a possibility. This
highlights the importance of a sound consent process that
shares the decision making with the patient about any clinical
management or procedure you propose.
Patients may also complain about non-clinical aspects of their
experience. These could include: fees that were charged, the
amount of time kept waiting in the reception area or breaches of
their privacy. These too can be linked back to their expectations
not being met in some way.
How do I respond to a patient complaint?
When a patient complains it can be important to them that
their grievance is heard, acknowledged and understood. Often,
they would like details and a further explanation about their
concerns. They may also like an apology if something went
wrong or was perceived by them as having gone wrong.
Most patients who have had a bad experience, significant
enough to complain, would also like to see some improvement
or change. This is to reduce the risk of something similar
happening to someone else.
When you receive a complaint directly from a patient, the initial
response is crucial and will influence the patient’s decision
to potentially escalate their concerns further - to their lawyer
or a complaints entity (for example, Ahpra or the Information
Commissioner). For this reason, it is important that your
reception and administration staff understand the significance
of their responses if they are the first point of contact.
If patients perceive that their complaint is being taken seriously
and is being handled by someone with sufficient authority
and sensitivity to address and resolve their concerns, they are
generally more likely to accept the outcome.
Have a complaint handling protocol
You should have a protocol at your practice for dealing
with complaints from patients. This will help you deal with
complaints in a systematic way. All protocols in your practice
should also be supported by training for your staff, so they are
aware of the protocol and their responsibilities.
Protocols should outline who is responsible for dealing with
complaints. We recommend that you designate a staff member as
the single point of contact for all complaints about your practice.
Doctors should then seek to deal with complaints about clinical
care but complaints about the practice or administrative issues
could be dealt with by the practice manager.
It may be appropriate to discuss patient complaints at practice
meetings and include the discussion in the minutes of those
meetings. This will demonstrate that the complaint has been
considered and allow for improvements in the practice to
be discussed.
Responding to the complaint
It is important to act promptly, do not ignore complaints. If a
complaint cannot be dealt with immediately, acknowledge that
you have received the complaint and let the patient know when
they can expect a response.
One aim of resolving the complaint early is to try to preserve the
therapeutic relationship with the patient. This involves listening
to the patient’s concerns and showing empathy, even if you
think the complaint is trivial or you do not accept the basis of
the complaint.
Steps to take in response to a complaint:
Consider whether you need specific advice from Avant about
the complaint and/or plan of management before you respond.
Where possible and appropriate make personal contact with the
patient by phone.
Make sure you fully understand the nature of the complaint and
the patient’s main concerns. You may need to take some time to
gather the facts but advise the patient if this is the case.
Where appropriate, suggest a face-to-face meeting to discuss
the patient’s concerns. Encourage the patient to bring a relative
or friend to accompany them if they wish. Suggest an interpreter
if language is a barrier. Allow plenty of time. Find a quiet, private
room for the conversation. It is advisable not to charge the
patient for this discussion.
Show empathy to the patient even if you do not accept the basis
of the complaint.
If the patient has had an unexpected or adverse outcome,
acknowledge the patient’s distress and, if appropriate, validate
it. If you are also upset about an outcome, tell the patient, “This
is not the outcome either of us wanted or anticipated”. There is
nothing wrong with demonstrating empathy or apologising.
In most cases it will be appropriate to follow up the discussion
with the patient with a written response. An effective response
usually contains the following elements:
- Acknowledgment of the patient’s point of view.
- A description of the factual information to address the
issues raised.
- Clarification or correction of misunderstandings.
- An apology.
- A description of changes that you will make in your
practice to avoid a similar set of circumstances, or at
least an assurance that you have considered the patient’s
comments carefully.
- A suggestion for an action that may resolve the
patient’s complaint.
Improvement options
Consider the factors that led to the complaint and whether
there are changes that can be made to prevent a recurrence.
If so, tell the patient, as they will wish to see that you take the
complaint seriously and that it will make a difference.
Every complaint should be a learning opportunity – use
complaints to recognise possible problems with your systems or
expectations of your patients.
With every complaint ask:
- is there more training of staff required?
- how can we prevent a recurrence?
- what can we do to improve?
Delay billing the patient or pursuing payment until the
complaint has been resolved. Pursuing payment when there is a
complaint can lead the patient to take the matter further. As an
act of good will, consider not sending a bill.
Sometimes, despite your best efforts, the therapeutic
relationship will have broken down to such an extent that you
feel the relationship can no longer be sustained. There are ways
of managing this, see our factsheet: How to end the doctor-patient relationship
Looking after yourself
One study found that 95% of doctors experienced some degree
of stress during the complaints process. This stress is at its worst
when you initially receive the complaint. It can interfere with
your professional and personal life.1
It is important to take care of yourself and seek support if you
need it. Please see Avant’s Health and Wellbeing resources for
more information.
Additional resources
1 Bismark, M., Spittal, M., Studdert, D., (2013) Identification of
doctors at risk of recurrent complaints: a national study of
healthcare complaints in Australia. BMJ Qual Saf 2013;22:10
879880 doi:10.1136/bmjqs-2013-002340
Avant factsheet: Responding to negative feedback online
For sample complaints handling protocols, template letters and
other useful resources, see Australian Commission on Safety and Quality in Healthcare’s Complaints Management Handbook for Health Care Services
For more information or immediate medico-legal advice, call us on 1800 128 268, 24/7 in emergencies