Avant - Mutual Group

  • What should I do if I receive a complaint?

    The first you may know of a patient complaint is when you receive a letter from either AHPRA or a health complaints body.

    The letter will normally come with a copy of the complaint (or “notification”) enclosed. The complaint may be made through a formal notification or by letter, email or even a telephone call. A complaint may be made by a patient, a hospital, a colleague or on referral from the coroner following a coronial inquest.

    At this early point in the process it is important to ensure you:

    • DO NOT contact the patient or the person who has made the complaint. This could be interpreted as an attempt to dissuade that person from complaining or to encourage them to withdraw their complaint. Such a move could be considered inappropriate conduct.
    • DO NOT contact AHPRA or the complaints entity until you have sought advice from Avant – if emotions are running high you could say something to the assessment officer that may hinder resolution of the complaint.
    • CALL AVANT – it is safer to share your feelings with us, and to seek our advice on how best to respond to the complaint.

    Preliminary assessment

    Normally the first stage in a professional conduct complaint is the assessment stage. Depending on the State you are in, this usually involves consultation between the complaints-handling entity (eg AHPRA or the HCCC) and the Medical Board (or in NSW the Medical Council) to decide who is going to deal with the notification. If the Board deals with the notification then it must, within 60 days, carry out a preliminary assessment. In most States AHPRA assists with the preliminary assessment.

    The Assessment Officer gathers the appropriate information to enable as assessment of the complaint. The Assessment Officer may:

  • Contact the complainant to clarify the notification
  • Seek a response to the notification from the doctor
  • Seek to obtain the patient’s health records to enable a clinical assessment of the care provided

Preparing a response

The Assessment Officer usually allows you 14 days (this time can vary) to provide a written response to the notification. Avant has been assisting doctors to prepare responses to complaints for many years and in our experience a response that is professional, factual and that displays insight into the patient’s complaint is more likely to result in a good outcome for the doctor.

If you require more time to make your written response it is best to contact Avant and we will seek an extension for you.

An effective response usually contains the following elements:

  • Acknowledgement of the notifier’s point of view. It is helpful to remember that the patient genuinely believed in their complaint and so an insightful conciliatory response may assist in resolving their concerns.
  • Provision of factual information to address the issues raised. Where possible your response should be supported by entries in the patient’s medical record.
  • Clarification or correction of misunderstandings.
  • An apology – either for the problem perceived by the patient, or sometimes (carefully) for an outcome referred to in the complaint.
  • 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 notifier’s comments carefully.
  • A suggestion for an action that may resolve the patient’s complaint; e.g. ‘I will forward a copy of the records to Dr Y immediately’ or ‘in hindsight, I recognise that while I am not prepared to sign the letter that Mr V has prepared I could prepare a factual medical report for his solicitor’.

Ask Avant to review your response

Before preparing your response you should consider who has made the complaint and whether you will be breaching a patient’s confidence in providing a response; your Avant Medico-Legal Advisor can guide you on this. Despite your best efforts it can be very difficult to maintain your objectivity in the face of a complaint about your professional care and therefore it is wise to allow us to review any response you have prepared before you provide it to AHPRA or the health complaints entity. Please try to provide your response to us as soon as possible. This gives us time to review the response and discuss recommended amendments with you.
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