Doctor’s misguided ‘compliment’ triggers patient complaint

17 August 2018 | Helen Turnbull, BA, LLB, Special Counsel – Professional Conduct, Avant Law, NSW

It could be a humorous or off-the-cuff remark, but sometimes all it takes is one misplaced comment to trigger a patient complaint.

In one example*, a young mother presented to a dermatologist for the first time, to have a mole checked, with her two toddlers in tow. The dermatologist noted that she looked tired and stressed as she sat down. She struggled to hold her two-year old daughter on her lap, while scolding her four-year old daughter for picking up the dermatologist’s glasses case.

The mother apologised to the dermatologist and remarked that “It’s been a long day looking after these two.” In an effort to break the ice, the dermatologist responded by telling her she “looked like a teenager rather than a mother of two kids.”

The patient was immediately insulted by the dermatologist’s comment and said she was sick of people insinuating she was too young to be a mother. The dermatologist was taken aback when the patient abruptly left his consultation room with her children, furious. Subsequently, the patient complained to the state’s complaints body about the dermatologist’s manner.

We assisted the member with their response, which included an apology for offending the patient and demonstrating insight on how the remark could have been considered inappropriate. Fortunately, in this case, the complaints body decided no further action was required.

However, in more extreme cases, doctors have been referred to a panel or tribunal hearing as the result of a patient complaint regarding an inflammatory remark. If the doctor is found guilty of unprofessional conduct, this can lead to a caution or conditions imposed on their registration. Not to mention, the significant impact this has on the doctor’s reputation.

Think before you speak

Avant’s claims data⁺ shows 37 per cent of all complaints against doctors about their professional conduct have communication as a factor.

Misplaced comments can be misinterpreted due to a variety of reasons including cultural differences, and the use of jargon or conversations being taken out of context.

Some doctors may use humour as a coping mechanism to deal with the stress of dealing with sick patients and working long hours. Whilst this may be acceptable between like-minded professionals, humour may be misplaced when dealing with patients. Although unintentional, many patients could be offended by humorous remarks, and see the doctor as lacking professionalism and empathy.

Tips to avoid a similar complaint

Follow these tips to minimise inadvertent comments like the one above, which may cause a patient offence:

Think before you speak – patients are often experiencing physical and/or emotional stress, and may not share your view, jargon or sense of humour.
A patient’s tone, words and behaviour can indicate how they feel about a situation. You should take your cues from the patient and this should guide your responses.
Communicate clearly – your words may be taken out of context and misinterpreted, thereby leading to a complaint.
Be aware of the patient’s disposition – facial expressions are sometimes worth a thousand words. Observe their reaction to the information you are imparting and your manner. Clarification can often avoid misunderstandings and/or complaints at a later date.

If a remark inadvertently causes a patient to feel humiliated or insulted, it is important to offer the patient an apology. Patients usually respond favourably and it can prevent a formal complaint from eventuating.