HELP: I've received a complaint – now what?

Many doctors, at some stage in their career, will receive a complaint from the HPCSA. Whatever the complaint, these practical tips explain what you should do next

Receiving a complaint can be stressful. As a junior doctor, especially, it can knock your confidence, but it is important to remember that many doctors do receive a complaint at some stage. It is not necessarily an indication of poor clinical performance. Handling a complaint requires time and commitment during a period when you might be feeling at your most vulnerable. But getting it right can pay huge dividends – and it marks you out as a true professional.

“The first thing to do is keep calm – though easier said than done, try not to panic,” says Head of Medical Services for Southern Africa Dr Graham Howarth. “Read the HPCSA’s letter again carefully – you won’t have digested all of its content during your initial reading. It’s important to understand exactly what the patient is complaining about. Is it your attitude, your diagnosis, a clinical error, or something else?”

Once you understand what the complaint is, you need to work out how to respond to it. “The next thing you should do is contact Medical Protection as soon as possible,” advises Dr Howarth. “Our medicolegal advisers are able to provide you with support and help you formulate a response to the complaint.”

At some stage during the course of dealing with a complaint, it is likely that you will need to send a written response, either in reply to a letter of complaint, or following a meeting with the complainant. We can provide specific assistance and support with this for your individual complaint. In general, when composing your letter you should take into account the following:

• Identify the concerns that have been raised and respond to all parts of the complaint. It is often helpful to set out an account of what took place, even if this is background information, but do not lose sight of the issues.
• The purpose of your response should be to try and resolve the complaint, not to perpetuate correspondence. Be courteous, objective and professional.
• Establish the facts before attempting to provide a full response to a complaint. Take time to present a measured, considered and considerate response, bearing in mind the timescales. Try to review your records before you draft your letter. Likewise, if you will be making reference to any other individual whose comments are required, obtain those comments wherever possible.
• Be aware of patient confidentiality. Not all complaints are made by the patient personally. Where a complaint is made about the service provided to a patient who has the capacity to give valid consent, that patient’s confidentiality must be respected.
• Try to be sympathetic and understanding. Offer condolences if these are due. Do not be afraid of apologising if an error has been made.
• Avoid blaming or judging others.
• Avoid jargon – use plain language.
• Your response should be typed, so that it is clearly legible.

What not to do

Community Service Officer, Dr L, was working in a rural area. He received a letter from the HPCSA regarding a complaint from a patient, Ms D. Dr L was infuriated. The complaint related to a minor clinical oversight, which had had no clinical effect on Ms D. Dr L felt that the complainant was suggesting he had completely missed an obvious diagnosis and was not competent to practise as a result.

He felt that the complaint was defamatory and immediately wrote a curt letter of response, rebutting the allegations and outlining his concerns that they had been raised in the first place. He then contacted Medical Protection and informed the medicolegal adviser that although he had received a spurious complaint, he had dealt with it. Dr L also requested assistance in suing Ms D for defamation.

Learning points

• However spurious or frivolous a complaint may seem, all complaints should be investigated and responded to appropriately. If a patient makes a complaint, the HPCSA is duty-bound to investigate it.
• If you are the subject of a complaint, take a moment to stop and think before responding. A well thought-out letter of response is far more likely to be successful than an intemperate one, which will only serve to make matters worse.
• Dr L should have contacted Medical Protection before responding to the complaint, as we would have written a letter of response on Dr L’s behalf. Medical Protection is unlikely to assist members in suing for defamation in response to a complaint made by a patient.
• While not relevant to this case in particular, it is also worth noting the importance of keeping your contact details up to date with the HPCSA. 

The case in this article is fictional but is an example of a common scenario that might occur in medical practice.

More support from Medical Protection
If you need advice, contact a medicolegal adviser at medical.rsa@medicalprotection.org
or 0800 982 766.