A patient tells you they are unhappy with you and the treatment you provided. It is a heart-sinking moment, creating all manner of emotions, including frustration, resentment, a fear of being overwhelmed, a feeling of being ‘de-professionalised’, anger, helplessness, hopelessness.

These feelings, while understandable, are also unhelpful in formulating your response to this dissatisfaction, as you may ‘react’ to the situation with emotion rather than ‘respond’ in a professional manner. They are also unhelpful to you, as they may lead to long-term stress and the consequences of this for your physical health and emotional wellbeing are well documented.

When we consider how to handle patient dissatisfaction or a complaint, our approach should be threefold:

•  resolve the patient’s concerns

•  care for ourselves throughout the process, and beyond

•  audit to safeguard against future complaints of this nature.

The first steps

A patient complaint needs to be acknowledged in a timely fashion. But what is considered timely? Depending on the setting, there may be different expectations for acknowledging complaints.

In general, the acknowledgement timeframe for complaints received within the practice regarding public dental care is five working days.

Quite often, private practices will have a similar timeframe in place for acknowledging patient complaints and you should review your own practice complaints policy for clarification. 

Acknowledging a complaint when it is being expressed to you directly is simple, although you should take care to respond appropriately and not ‘react’ to this potentially stressful situation. Many practices, however, forget to acknowledge a written or emailed complaint.

• At the initial stage, having received a complaint, it is not necessary to provide a fully reasoned response. It is suitable for the practice to provide your patient with an acknowledgement to their complaint, so they know it has been received and that you intend to reply comprehensively. As part of this acknowledgement, the patient’s expectations regarding ‘what happens next’ need to be set.
• Does the patient need to provide any additional information? For example, the records of, or a report from, their new dental practice, if they have sought treatment elsewhere?
• How long will it take you to assess this matter – when should they expect to hear back from you?

It is important that every staff member who deals directly with patients has the ability and training to be a ‘first responder’ to a complaint, as not only will this give them greater confidence when these situations arise, but better early management will render the complaint far less likely to escalate to a third party (such as a solicitor) and potentially develop into a claim.

Staff can become defensive too and react when they believe that a complaint is being unfairly directed at them, or a patient is demanding an immediate response. A little training and a practice policy detailing steps to be taken can help both the patient and the staff member in these situations. Patients who complain and then feel that they have been ignored or, worse still, rebuffed, are more likely to escalate their complaint.

It can also be helpful to have a dedicated ‘complaints manager’ at the practice. Preferably someone calm by nature, this person could have additional training in complaints management and should be a good communicator, to enable them to establish rapport with the patient. All future communications regarding the complaint can then go through them.

Work through the patient’s concerns to reach a resolution

The mechanism for doing this will vary from case to case and will depend on the nature of the complaint, the severity of the complained adverse outcome (if there is one) and its consequences for the health or wellbeing of the patient and, above all else, the willingness of both parties to engage in reasoned conciliation.

Regardless of the nature of the complaint, if you have any doubts about the approach to take or your ability to resolve it amicably, you should contact Dental Protection for advice. Our advisers are experienced in resolving patient concerns and, just as importantly, can be a sounding board for your thoughts and concerns. We can provide an objective opinion on whether the complaint is reasonable, and tailor your response to suit the individual circumstances.

Take time for a debrief, and care for yourself

Feeling professionally challenged can be a terrifying and isolating experience. We may fear ridicule or a critical judgement from our peers because of the patient dissatisfaction, particularly if the patient had a genuine and legitimate reason to feel that way. We may feel that our reputation will be besmirched by a complaint and wish to keep the complaint or patient dissatisfaction to ourselves.

While all these reactions are understandable, they will not be helpful to you in the long term. Sometimes, as in this case, the old clichés are the best, and a ‘problem shared is a problem halved’. Talking through our complaints, concerns and distress with others can enhance personal growth and understanding. Furthermore, discussing our difficulties with others can help them recognise similar issues before they arise, and help them to better manage patient dissatisfaction in their own practice.

Audit

Finally, something that can be helpful, although it may seem slightly counter-intuitive, is to keep a complaint file. This is kept separate to the clinical notes for each patient. While this complaint file may sit empty for many years or it may only have one complaint in it, it is important to take the time to review any complaints received to see if there is a pattern of issues. Is it timekeeping, fees, or the way that the practice is making patients feel? If so, what steps can you take both personally and through the practice to safeguard against complaints of this nature in the future?

Conclusion

Dental Protection can offer you both support and advice during the often-stressful process of complaint management. We can assist with appropriate wording and help make this a learning exercise for the future. The essential elements are that a sympathetic, polite, and objective reply needs to be forwarded in response to a complaint in a timely manner.

FAQs

If the practice agree to provide a patient with a refund of fees, does this admit liability or wrong-doing on my part?
No, as long as you offer a refund of fees to a patient with a clear indication, preferably in writing, as a gesture of goodwill, this would not constitute an admission of liability.

The patient has demanded a response from the practice within seven days.  Do we have to follow the patient’s timeline?
No, while you would be expected to respond to a complaint within a reasonable timeframe, the patient should allow you sufficient time to investigate and respond to their concerns. The designated person for managing complaints within the practice, should manage the complaint and acknowledge this in line with the timeframes set out within the practice complaints policy. If the response is taking longer than anticipated, it is worthwhile sending a holding letter to the patient explaining the situation. This helps to manage the patient’s expectations for a response.

Can verbal concerns from a patient be considered a formal complaint?
Yes, any expression of dissatisfaction, verbal or written, is considered a formal complaint.  The practice should manage this accordingly, in line with the practice complaints procedure.  Where verbal concerns have been raised, it can be helpful to summarise these in bullet point format within the initial acknowledgement letter, to allow the patient an opportunity to clarify any information which may have been misunderstood/misinterpreted prior to investigation into their complaint.

My former practice has notified me of a complaint involving treatment I provided for a patient five years ago. Do I still need to respond to this?
You must remember, if a patient remains unhappy for any reason with the management of a complaint, there are many other avenues they can choose to pursue. It is always good practice to address any concerns which may arise regarding treatment you have provided to try and head off any potential unnecessary escalation of a complaint.