Many doctors will experience a complaint, investigation or clinical negligence claim during their medical career; it could come from a patient, an employer or via the Medical Council of Hong Kong, and could relate to any aspect of professional practice. Recent increases in the number of complaints made against doctors are likely due to the increasing complexity of medicine and an emerging complaints culture amongst the public, rather than any decrease in doctors’ performance.
What do patients complain about?
Patients can make a complaint about any aspect of the medical care they receive. Some common reasons for patient complaints include:
• Incorrect, missed or delayed diagnosis
• Delayed treatment
• Post-surgery complications
• Poor explanation of their options
• Inappropriate conduct or behaviour of the doctor
• Lack of informed consent (or capacity to consent)
• Breach of patient confidentiality
The list is not exhaustive – there are many examples of what can go wrong in a clinical setting. Doctors are, after all, only human and errors can occur despite their best efforts, particularly when they are working under pressure in a stressful environment.
What can happen following a complaint?
A patient complaint, or clinical incident involving a patient, can lead to many different types of investigation, for example:
• Disciplinary action by the employer
• Negligence claim (for financial compensation)
• Hospital enquiry
• An inquest if a patient has died
• Medical Council of Hong Kong investigation
• Criminal investigation
We encourage our members to contact us as soon as an incident occurs, so that we can offer advice on what to do next. Early intervention is key and can sometimes prevent an incident escalating into one or more of the other investigations listed above.
What risks might I face as a medical student?
Although not yet qualified, students can still receive complaints and may find themselves facing disciplinary action and investigations. Complaints could arise for various reasons, for example due to:
• Misconduct on social media
• Clinical mistakes, or poor communication, when working with patients
• Accusations of poor practice during your elective
If you’re worried about any current or potential issues, you can email us or call our dedicated student support and advice line on 0800 952 0442.
What risks might I face as a junior doctor?
Once you qualify, you face multiple occupational risks that could unfortunately have grave consequences for your career, reputation and finances.
Above we covered some of the main reasons why patients complain and the various consequences that can arise from a complaint. However, the specific risks you may face will depend on what type of doctor you become. For example, will you be diagnosing patients, treating patients, or a combination of both?
The nature, quantity and severity of complaints also varies by specialty. Did you know, for example, that obstetricians are more likely to face high-value clinical negligence claims?
This may all sound incredibly daunting, but help is available; medical defence organisations like Medical Protection exist to support doctors in such situations.
How can I avoid patient complaints and other medicolegal problems?
“Prevention is better than cure”. It's a well-known phrase in medicine, and it’s also true where medicolegal issues are concerned.
You can help protect yourself from future complaints and claims by being aware of potential risks and taking steps to mitigate these before an incident occurs. Most patient complaints relate to one or more of the following areas:
Being aware and knowledgeable about potential risk will have a positive impact on your behaviour and clinical performance. Here are our suggestions:
Stay up to date
Keep abreast of the latest developments in healthcare, such as news, policy announcements, and important changes to regulations and legislation.
Work on your ‘soft’ skills
Are your organisational skills up to scratch?
It is common for medicolegal cases to involve poor record-keeping.
Do you communicate effectively with both patients and colleagues?
Patients will usually appreciate honest, open doctors who communicate effectively, explain issues clearly, and apologise appropriately when things don’t go to plan.
See also Surviving Medical School: Communication between colleagues
Learn from others’ mistakes
Many doctors have found themselves in tricky situations; learn from them so you don’t end up in the same position. Read our case reports here.
Take online courses
Medical school doesn’t cover everything. If time allows, take additional online courses.
Helping members to avoid problems before they happen is central to our approach, so we provide a wide range of educational resources and workshops covering areas such as:
• Medicolegal issues
• Professionalism and ethics
• Communication and interpersonal skills
• Systems and processes
• Clinical risk management
Log on to PRISM here
What if I make a mistake?
Sometimes prevention isn’t enough and even the best, most diligent doctors find themselves facing complaints and legal action. At this stage there are still steps you can take to protect yourself.
Recognise and report early
Contact your medical defence organisation as soon as possible. We encourage members to contact us as soon as an incident occurs, as we may be able to prevent it from escalating to a more serious problem. Our medicolegal consultants have extensive experience with a wide range of issues – major and minor – and they can advise you on what to do next.
Rectify the mistake and prevent further harm
Take responsibility for what’s happened and do what you can to rectify the situation. You can’t undo the mistake entirely, but you may be able to prevent the patient coming to any further harm.
Speak to the patient and family
Be honest. Listen and respond to their concerns.
Learn from mistakes
Resilience and continuous development are part and parcel of being a great doctor. Use negative experiences as learning opportunities and take steps to ensure the same errors are not made again. Did the experience highlight problems in the wider team, such as poor communication or inadequate administrative processes? If so, raise these with a more senior colleague to minimise the chance of a repeat issue.
How Medical Protection can help
Receiving a complaint or claim is incredibly difficult for any medical practitioner. Alongside the inevitable emotional stress, doctors could find themselves facing financial penalties, reputational damage and potentially withdrawal of their right to practise medicine.
When such incidents occur, members of Medical Protection should contact us so we can provide expert advice and support.
However, we’re not just there when things go wrong – members can contact us at any time for advice on risk mitigation and professional ethical dilemmas.
We also help all our members proactively reduce their risk of facing medicolegal issues by giving them access to a wide range of educational resources like articles, case reports, and online learning modules.
If you need advice at any time, don’t hesitate to email us or call our dedicated student support and advice line: 0800 952 0442
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