Dr Malpani explains how doctors need to talk to patients in order to reduce complaints

Effective communication with the patient plays a key role in the prevention of patient complaints and litigation.
http://www.avant.org.au/Getting-Started-in-Practice/Practice-Management/Communications/Patient-centred-communication/

Dr Malpani's review on Handling Patient Complaints

Monitoring and reviewing complaints should be part of every doctor's practice. Information about near misses, adverse events and complaints provides an opportunity to improve the standard of service and care.


This article provides a very useful practical resource for all doctors on how they should handle patients complaints .

http://www.avant.org.au/Getting-Started-in-Practice/Practice-Management/Communications/Handling-patient-complaints-and-dispute-resolution/

Avoiding patient complaints - a guide by Dr Malpani

Unhappy patient's are a doctor's nightmare. This is especially true for an IVF clinic like Malpani Infertility Clinic, which depends upon patient's referrals to get new patients. We take pride in delighting our patients,  so that they can refer other infertile couples to use.


Of course, we can't keep everyone happy all the time, and there are going to be infertile couples who are not going to be happy with us - especially when their IVF cycle fails.


Although complaints are based on multiple factors, several common issues underlie most patient complaints. We try to minimize our risk of patient complaints about Malpani Infertility Clinic by paying close attention to these four key areas.

1) Enhancing communication
Communication is a key issue in avoiding patient complaints. Because many patients have difficulty absorbing—or understanding—the information presented to them, we develop resources such as e-learning courses and an IVF comic book, so that they have realistic expectations of the IVF treatment.

2) Practicing cultural competence
Our patients come from a variety of cultures from all across the world. Language barriers can make communicating with the patient quite challenging. Often, patients’ cultural backgrounds affect how they relate to healthcare providers or process information. In certain cultures, for example, asking a physician questions may be considered rude or a challenge to authority. We are therefore very proactive in making sure patients understand that lots of IVF cycles fail, no matter how good the IVF clinic is !

3) We respect the informed consent process
Informed consent is a process, and the “informed consent sheet” commonly seen in medical records is simply the documentation of that process. Not only do we explain the risks and benefits of IVF through our educational materials, we also discuss alternatives to IVF, such as surrogacy and adoption.


4) Explaining all charges and fees up front
We make sure that all charges are clearly explained to the patient. This is why we offer a package fee option, so that there is no sticker shock or unpleasant surprises later on. This is also why we publish our fees on our website, so there is no scope for confusion !

Classifying Patient complaints - A review of a BMJ article by Dr Malpani

Patient complaints are a valuable resource for monitoring and improving patient safety. This free article ( Patient complaints in healthcare systems: a systematic review and coding taxonomy at qualitysafety.bmj.com/content/early/2014/05/29/bmjqs-2013-002437.full) reviews the literature on patient complaints, and helps doctors to classify them.

While the article is fairly complex and technical, the classification system the authors have developed is comprehensive.

The Best Way To Handle Patient Complaints

Patient complaints are not uncommon. Doctors sweat to serve their patients in every way but a few patients are bound to be dissatisfied by one factor or the other.

These  complaints are usually inspired by minor reasons. In most cases the reason is either the administrative staff behavior or some clerical problem. Some patients expect VIP treatment from the doctor at all times of the day which is practically impossible.

Patients may feel they have been cheated when they do not get the degree of attention they want. Patients coming to an infertility clinic are often very emotional and overly sensitive and may get upset by the smallest problems. They are often fed up of going to doctors and getting probed and prodded endlessly.

It is essential for medical staff to handle these complaints with a sensible attitude. Avoiding the patient or just ignoring the complaint makes matters worse. The solution does not lie in turning a blind eye towards the cause. The doctor should take it as a golden opportunity to improve their services.

The doctor needs to listen to the patient’s complaints. Some patients feel better once they realize that the doctor is there for them and is ready to listen to their problems.  Most of them are relieved after venting out their frustration.

The doctor should not get defensive and learns to take a rational approach towards the problem. If the doctor finds he has to address the same problem repeatedly then it would be prudent to analyse and fix the cause of the problem , rather than just handling the complaint itself.

The Commonest Complaints Patients have About Their Doctors

There is no patient who cannot recount horror stories about doctors. If you ever reveal yourself to be a doctor at a random party, be prepared to be regaled with endless complaints as to how terribly insensitive and uncaring doctors are these days. Apparently, their legendary family doctor was far superior  and everyone fondly remembers the caring doctor of yore, who made house calls and was a friend, philosopher and guide along with being a doctor !

That doctors do not share information with them is by far one of the most common complaints. This is a rightful complaint as doctors, being busy, do not share information with their patients unless they feel that the patient needs it. If the patient’s health is improving they feel that it is useless to burden them with information about their pathophysiology and differential diagnosis. But if the patient doesn’t get better, they will most likely have complaints against the doctor for not sharing all information with them. Assuming that he deliberately withheld information they imagine that the doctor is simply out to cheat them. But the fact is, he may simply have been too busy to reveal information to them.

It is a waste to make complaints that your doctor does not share information with you. You only become sulky, enraged, sad and bitter with your doctor being none the wiser about your resentment. Your doctor most probably thinks he has told you whatever you need to know.

Learning productive strategies to work as active partners instead of being passive recipients of treatment can be a wiser approach for patients. It is best to turn confrontational with the doctor only if the output is bad. Patients need to learn to be more assertive instead of being inert.

If you want more light shed on what information you need to maximize your chances of IVF success, please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !

Dr. Malpani’s Advice for Doctors on how to deal with Patients’ Complaints

Doctors put in their best efforts to care for their patients. They often work hard and long hours just to ensure the best of health for their patient. Nevertheless, some patients have complaints about the kind of care provided by the doctor. These complaints could frequently be unrelated to the doctor’s behavior or actions. The patient could probably be angry for having had to wait too long or because the receptionist was ill-mannered. Some patients even have the unfair expectation that the doctor will see them first, out of turn, even though they know that the doctor has other patients to see before them, who have been given earlier appointments.

Being unhappy for some reason, patients complain. Unfortunately, most doctors are clueless about how to handle these complaints from their patients.

However, it is important for doctors to remember that medicine is a profession based on service and therefore, complaints offer an opportunity to recover when the patient perceives a deficiency in the service she has received.

Dr. Malpani advises doctors not to lose their temper or ignore complaints. It is better to empathize with the patient in their situation. They do not particularly like coming to doctors and because they are anxious about their health, they are not very emotionally strong.

Refusing to see the patient or dismissing their concerns only causes a bad situation to become worse. A minor issue which can be resolved amicably can quickly escalate to become ugly.

It’s best to believe that patients are generally sensible and rational, and wouldn’t complain hadn’t they a very good reason to do so. Complaints can be seen positively as opportunities to solve problems by investing time and effort. By doing this, the concerned patients are impressed with your attitude and turn from, being critic into becoming supporters.

Investigating and resolving patients’ complaints is worthwhile. If one patient complains, there may be ten others who may not bother to do so, but instead silently walk away and seek another doctor .

Do you feel your IVF doctor has treated you badly ? If you want to find out if you have valid reasons to complain, please send me your medical details by filling in the form at www.drmalpani.com/malpaniform.htm so that I can guide you better !