The hidden risks in patient complaints

Patients come in many shapes and sizes. So do their complaints – from the seemingly trivial to the ones that will obviously trigger a malpractice lawsuit.

A practice that masters the management and methods of complaint resolution is ahead of game in avoiding grievances, medical board complaints, or worse, the courtroom.

The root of patient complaints was recently identified as a failure to recognize and manage patient expectations. Many complaints and malpractice lawsuits are rooted in the patients' failure to understand the expected results and risks about their health care. The annual benchmark report authored by Harvard university identified in simplified terms that the successful physician is one who can assess the level of understanding and expectations his or her patient has for the proposed surgery or procedure.

When expectations are not met, the assumption is that the unexpected result is the product of error vs. a realized risk and complication of treatment. This places the burden on the physician and sometimes the health care team to explain or "disclose" in a manner consistent with the patient's level of comprehension why his or her expectations are unrealistic or why you are not negligent with your care.

Risk Strategies

First and foremost, a medical practice is a business. It must have a business license to be open. As with any business, customer service and customer satisfaction are an inherent element in any business venture even those that "sell" health care services vs. other products.

· Do you have a system in place to identify and capture patient complaints?

· Is your staff encouraged to report problems and negative patient comments they observe or receive?

· Do you have staff with the social skills and experience in complaint resolution?

Many staff members see their role as "running interference" between the doctor and the patient to protect them from unnecessary phone calls or "troublesome" patients. Such notions actually propel you into the fast lane for legal grief. Patients who learn their doctor will not listen will find an attorney who will. Are you even aware when a patient is angry?

Expectation Management and Consent

If managing patient expectations is the means of decreasing patient complaints, then consent is an important aspect of expectation management. Your consent discussion has evolved to being the most crucial event in managing your patient's care. An intelligent assessment of the patient's understanding of the expected results and its risks in the pretreatment phase is the foundation for managing any complaints that follow. The failure to embrace this concept means an increased risk of finding yourself before the Medical board or worse – the courtroom.

Develop and encourage a patient-centered culture in which patient safety includes both managing patient expectations and the preservation of patient satisfaction and customer service. Consider using patient satisfaction surveys as a tool to measure the effectiveness of your efforts and identify ways to improve what you do and how you do it. And if you need advice on managing patient expectations.

Evidence supports that happy patients don't complain, and patients who understand a complication of care is not an "unexpected" result don't sue.

Lee McMullin is a certified Professional in Healthcare Risk Management with more than 25 years of experience in claims and risk management. He is part of the CAP Cares Team which supports the CAPAssurance program offering hospitals, large medical groups, and other health care facilities top-rated risk management services

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.

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