Benefits of Setting up Grievance Procedures

Staff Report

Kathryn Moghadas, a registered nurse, warns that a patient’s unresolved complaint about you or your office could evolve into a lawsuit.  This article summarizes her advice on how physicians can implement a written grievance process that provides patients with a way to get action on a problem before it escalates into a larger issue or becomes a lawsuit.

In an ideal visit, the appointment is on time, the staff is friendly and knowledgeable, and the doctor listens to the patients concerns and then performs the appropriate exam or explains a medical decision, prescribes a treatment, and asks for any questions or additional concerns.  But some visits are not perfect and patients will have complaints.

If a patients leave with an unresolved complaint, they may talk about their “poor” treatment to their friends and relatives directly or express the grievances on a M.D. rating web site which are now common. They may also complain to an insurance carrier or, worst of all, file a malpractice claim.  If a practice has a straightforward policy for handling grievances, it can be used to limit negative outcomes.  This policy can be short and succinct. The goal is to resolve complaints and gather information for corrective action to limit unhappy patients who may leave, denigrate the physician’s reputation or cause litigation.

Make Your Policy Known to Your Patients

Post your grievance policy where your patients can read it.  Provide a visible suggestion box and critique forms and a copy of the policy to patients at the reception window.  The policy should explain that the doctor reviews all complaints, major and minor, as part of the office improvement program.  It’s also important to clearly post how patients can contact appropriate managers at the practice to share their questions or concerns.  This helps to resolve problems early and avoid escalation.

Common Reasons for Grievances

Ms. Moghadas states that most common reasons for patient grievance are:

(1)  Failure to communicate

(2)  Failure to fulfill expectations for examination and treatment

Other complaints arise from prolonged wait time, rudeness of the staff and billing communication issues.  The first two reasons pose a litigation risk whereas all will cause the patient to leave the practice.

Basic Grievance Process Template

A basic grievance policy’s objective states that all complaints related to care or services are handled as courteously and quickly as possible.

    • 1.) The policy should designate the individual to contact for complaints or grievances
    • 2.) Train all staff members on the policy and the process
    • 3.) Provide an easily obtainable complaint form for patients
    • 4.) Staff must document verbal complaints
    • 5.) Investigate the underlying cause for complaint.
    • 6.) Develop corrective actions that eliminates the cause
    • 7.) Communicate the corrections to the patient