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Practice dilemma: Dealing with a patient who repeatedly complains

We have a patient who repeatedly complains. He isn't happy with any of the GPs he sees, he has also complained about reception and problems getting through on the phone. Every response we provide provokes another reply from the patient. We feel we have addressed his concerns and that his reaction is out of proportion to the situation. How can we handle this?

Dr Marika Davies, medicolegal adviser at Medical Protection advises:

Patients are entitled to complain. Some will do so more than others, and dealing with complaints is part of the day-to-day work of a GP and their team. But it can be very disheartening when you are faced with repeated complaints despite doing your best for a patient.

Dealing with a situation like this professionally and appropriately is essential in order to avoid the risk of criticism should he take his complaint further.

Review the correspondence on the complaints file to date carefully. You must be satisfied that all the patient’s concerns have been addressed, that he has been provided with a full explanation, and, where appropriate, an apology.

Offer to meet with him to discuss his concerns. Find out if there are any underlying issues or fears that are causing him to be unhappy with the practice and the care he is receiving. It is not too late to try to re-build your relationship with the patient, which may be helpful in seeking to manage his expectations of the practice and re-establish some of the trust that may have been lost.

If you identify any outstanding complaints then these should be investigated under your complaints procedure in the usual way. It is important to be objective in doing so, and you should provide the patient with details of your local complaints advisory service.

Once you are satisfied that all aspects of the patient’s complaints have been addressed you should advise him that local resolution is at an end, and that he has a right to take his complaint to the Parliamentary and Health Service Ombudsman.

Can you remove the patient from the list?

Removing the patient from your practice list may be tempting, but doing so risks criticism from the Ombudsman, the GMC, and the media. Patients should not be removed in response to lodging a complaint, or because they are highly demanding.

The GMC says: ‘You should not end a professional relationship with a patient solely because of a complaint the patient has made about you or your team, or because of the resource implications of the patient’s care or treatment.’

It may be justifiable to remove a patient where the doctor-patient relationship has irretrievably broken down, but this should be a last resort, and doctors should seek advice from their defence organisation before doing so.

There is no doubt that providing care to a patient such as this, and dealing with his complaints, can be stressful. Make sure those staff members who are involved feel supported and that there are opportunities for them to discuss developments and debrief with colleagues.

Consider reviewing the matter under the practice significant event process to see what lessons can be learned, both about the clinical management of this patient and his wider concerns. It is a good idea to contact your defence organisation for help in dealing with this difficult situation.

More information on handling complaints on Medeconomics

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