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Why do patients complain?

10 February 2021

Many doctors will experience a complaint, investigation or clinical negligence claim during their medical career.

These complaints could come from a patient, an employer, an employee, a fellow practitioner or via the HPCSA and could relate to any aspect of professional practice.

Complaints against doctors have unfortunately become more common in recent years. This is likely due to the increasing complexity of medicine and an emerging complaints culture amongst the general public rather than any decrease in doctors’ performance.

Patients may complain about any aspect of the medical care they receive. Some common reasons for patient complaints include:

    •  Incorrect, missed or delayed diagnosis and treatment
    •  Delayed referral to specialists or other practitioners
    •  Post-surgery complications
    •  Poor explanation of their treatment options with resultant lack of informed consent (or capacity to consent)
    •  Poor explanation of side effects and effects of medication prescribed
    •  Inappropriate conduct or behaviour of the doctor
    •  Breach of patient confidentiality
    •  No feedback or communication from the doctor
    •  Blaming the doctor for medical aid issues

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 investigations, for example:

    •  Disciplinary action by the employer
    •  Negligence claim (for financial compensation)
    •  Complaint processed through the HPCSA
    •  Hospital enquiry
    •  An inquest if a patient has died
    •  HPCSA 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 fitness to practise investigations. Complaints could arise for many 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 student 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.

We have 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. It is important to note that if you work for a state facility, that Medical Protection may not be able to assist due to state indemnification.

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.

For more information see 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

Medical Protection members can access this content by logging into PRISM.

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 advisors 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 studies, events and webinars.

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

Students - Join Medical Protection for free