Why physicians should welcome patient complaints

Physician communication is the number one factor most highly correlated with the likelihood that patients will return to a hospital or medical practice. This conclusion is one that I have personally experienced and highlighted as a speaker at healthcare conferences and seminars and when consulting with fellow physicians on improving communication and building and maintaining a successful practice.

Physician communication is so important because understandably patients are anxious about their health and healthcare and rely on providers, especially personal physicians, surgeons and specialists, to ease their anxiety and address their concerns.

Another factor that cannot be overlooked is that communication problems cause the vast majority of malpractice lawsuits. In fact, physicians in the lowest third on communication ratings have 110 percent more lawsuits than those in the top third.

Effective patient-centered communication by physicians significantly improves the odds that patients will adhere to the recommended treatment plan and will be much better in self-management of chronic disease, resulting in improved patient outcomes for diabetes, hypertension and cancer. And this is what we all desire.

In addition, several studies have established that physicians who communicate well with their patients find that their work is less stressful and more fulfilling than those who do not.

When thinking about improving communications physicians can rely on this key principle – Turn up the warmth and you’ll turn down the heat. A best practice approach to handling patient complaints includes these steps:

  • Listen to the patient’s story or concern.
  • Empathize.
  • Use a blameless apology.  Express sincere regret that the person has in any way suffered without blaming anyone for the problem.  “I’m so sorry the wait was so frustrating for you.”
  • Act:  Do whatever you can to remedy the problem.
  • Thank the person for speaking up.

And when responding to patient complaints the successful physician communicator will avoid these practices:

  • Discounting what the patient says (“That couldn’t be. We don’t do that here. You don’t understand. That shouldn’t upset you.”)
  • Arguing and making excuses (“There were good reasons for that.”)
  • Blaming others or the organization (“Sorry.  It’s a zoo here!” Or “Sorry, that happened because we’re short-staffed.”  Or, “That doctor always does that.”)

When thinking about best practices for handling complaints physicians will want to remember that complaints are inevitable, no matter how skilled, professional, and caring you might be. The science and art of handling complaints well is called “service recovery.” And most important, physicians should welcome complaints because when people speak up about their dissatisfaction it gives us a second chance to make things right.

When you handle complaints well, you can often create an even more satisfied patient who is grateful for your responsiveness, will continue to return year after year, and will brag to friends and family about what a wonderful physician you are.

Carla J. Rotering is vice president, physician services, Leebov Golde Group. She is the co-author of The Language of Caring Guide for Physicians: Communication Essentials for Patient-Centered Care.

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  • Suzi Q 38

    This should be emailed to two of my doctors, but they would not figure it out.
    I complained within a few months of my surgery about neuropathies and weakness in my legs. Not only did the doctor discount it, and outright deny that it could have come from his surgery, but he was angry. He wanted me to “wait and see.” I tried, but the problem persisted. I dreaded going in to tell him that I needed a referral to a neurologist. He asked me if I was sure that I needed it…..everything just got worse. My legs are barely weight bearing now. It turns out that I had a severe injury to my Cspine c4-6.
    The neurologist that he referred me to was more worried about my surgeon than me. They were both worried that I was going to sue, so the neuro did as little as possible for me.
    I even sent the surgeon a letter, asking for additional treatment, as the neuro wasn’t ordering much. My symptoms, had escalated, and all of it was painful and worrisome.

    Sadly, I would not have been angry or complained if he would have talked to me and gotten me care quickly. I have had my surgery, but at a different teaching hospital.

    I sent the advocacy a letter 45 pages long in 3 parts, documenting everything. I even have email correspondence. I had already requested my medical records long ago. My story reads like a novel. I still have to send the last part, complete with drama, but I hesitate to do so because I know that these two young and immature doctors may get reprimanded or let go. With the changes in health care due next year. They may be the first to go after my valid complaint.

    I don’t want to sue, I am praying that I will get well instead.
    Thank good ness I am a little better.

    • http://twitter.com/NYCPatient NYC Patient

      Sorry for your ordeal, Suzi. Mine is similar. One of my doctors actually “slipped” and outright said complaining to Pt Services only made things worse as they actually found (and admitted to) “areas of improvement” in his practice. He then decided to “discharge” me as a patient. My complaint to PT Svcs only came after MONTHS of errors and being bounced around, all while sensing the whole time they were being “distant” because of fear that I may sue the original surgeon at an “affiliated hospital.”

      • Suzi Q 38

        Yes. It is almost as if we are the “bad guys” for complaining when there is a medical error or perceived problem.
        It might not even be his error! It might just be me, and that is the way it is. The key is that I needed treatment.
        I know that these two doctors have learned. They are a little embarrassed, I sense that. They need to be.

        Once I figured out that I had a huge problem, I finished up my care and moved on to another hospital. I was careful not to complain about the first one. When the surgeon and neurologist asked me why I hadn’t had a full MRI and the diagnosis sooner, I made excuses for the first hospital. I told them “Well, doctor, it took awhile for them to find the problem, as they are not a neuro hospital, they are a cancer hospital.” Reality was that I wanted to leave sooner, but the PT convinced me to stay and the neuro convinced me that I was O.K. I was far from O.K.
        The new hospital understood why I was there. the new teaching hospital, while far from perfect, at least was a neuro hospital and had better and faster care for me.
        They just apologized that they could not do more for me due to the fact that the first hospital allowed it to get worse for too long. That was difficult to hear.

        I am complaining, but I have to be careful. I just want some answers, even though it will embarrass two doctors.

        I am the one that has the leg paralysis, they don’t. Why am I afraid of what they will say or think?

      • Suzi Q 38

        Sorry for your ordeal, too, NYC.
        Sometimes it is not worth it to complain.
        At a time when cancer hospitals are begging and advertising for patients, they will just have to do without me and my referrals.
        I have referred 10 or more in the past to their hospital.
        I ended up having my anterior c spine surgery somewhere else.

        i am thinking of writing an article in the major hospital.

      • http://www.facebook.com/carla.rotering Carla Rotering

        Thank you for sharing your experience – the more we know and share, the greater the difference we can all make!

    • http://www.facebook.com/carla.rotering Carla Rotering

      Thanks for reminding us – even through this challenging experience – that effective communication and caring will always be at the center of the relationship between patients and doctors.

      • Suzi Q 38

        Thank you.
        I read your article and realized that your suggestions to other doctors for dealing with concerns, complaints, and outright objections are excellent.
        Doctors need a meeting to train them on this very subject.
        It will make them better doctors.
        Not every surgery, case, and patient will be good or happy.
        Things happen.
        You are dealing with some risky surgeries, procedures, and treatments. Everyone is human.
        If a patient complains, h/she needs to be listened to, validated, and help should be given. No ignoring, not listening, delay of treatment or playing the “hot potato” game with h/her.

        H/she deserves the proper treatment, no matter if h/she erroneously views the problem as a bad outcome from a surgery or treatment. Don’t take it so personal or be so fearful of a lawsuit that you with hold treatment. Doing so may make things for the patient far worse. Now you have lack of treatment at a crucial time when treatment was necessary and critical to h/her outcome.

        if it is later discovered that you withheld care purposefully, then there is a possibility of a lawsuit. You will get what you were trying to avoid in the first place, and now you have a patient (like in my case) that suffers from avoidable partial paralysis.

  • http://www.facebook.com/carla.rotering Carla Rotering

    Thanks for your comments – and the reminder that the invitation to give voice to your experience (whatever that experience might be) even through a simple method like a suggestion box – is heartwarming and offers a way to implement small shifts that make a difference.

  • LBENT

    When I was the director of the Center for Pediatric Quality at the Children’s Hospital of Buffalo from 1995 through 2005, we not only welcomed complaints but also “incident” reports. The more the better. These are opportunities to find ways to improve. Not all are legitimate, but almost all will give insight and are an exercise is “listening” and then deciding a course of action for improvement.

    And the end of the story is a new administration came in and decided they didn’t like all these bad things and I was replaced.

    Excellent institutions and physicians shine lights on problems.

  • sparklingsoul

    Nothing makes me angrier than a “blameless apology.” A true apology entails accepting full responsibility for upsetting the other person: “I’m sorry for being late and inconveniencing you.”

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