What to do When Facing a Client Complaint
So it’s finally happened. An unhappy client comes to your door with a complaint. Don’t worry though, it happens to everyone. Being in an industry as emotionally fraught as healthcare always carries the risk of having to deal with an unhappy client sooner or later. When this happens, it’s easy to fall into the trap of thinking you are doomed to a long and difficult process that will seriously affect your career and business.
But handled correctly, a complaint may be the beginning of an opportunity. You can stop a problem before it starts. You can manage your client’s feelings and the emerging situation in a way that both allays their concerns and allows you to improve how you do things at the same time.
How did this happen?
Complaints can come from any number of circumstances, but most of the time they will relate to issues with communication, conflicts between client’s family members, disputes over access to records, or observations/conclusions that you make that the patient or family does not agree with. Privacy breaches are the most common and what will most likely require legal assistance to deal with.
How could I have avoided this?
You’ve heard the saying that “an ounce of prevention is worth a pound of cure,” and similarly the best way to deal with a complaint is to prevent it from happening. Consider adhering to the following steps when dealing with your clients to avoid conflict:
Set Expectations: Take the time to properly explain your office’s policies and procedures, the client’s possible options, and set appropriate expectations for the outcome.
Keep a Record: Create thorough notes, preserve communications, and document client visits in every interaction;
Prevent Surprises: SuRprises are not usually welcome by clients and indicate that there has been a breakdown in communication between provider and client.
Keep Out of Familial Disputes: Family conflict has the potential to spill out into your relationship with the clients. Avoid this by being clear about expectations and avoid being embroiled in conflict.
What is the process?
Whenever a client has a concern, they can express their dissatisfaction in a number of ways, a partially complete list of which is below:
An oral or written complaint to their healthcare provider or organization
A complaint to a regulated professional college (for regulated healthcare providers)
A complaint to an insurance company or funder
A complaint to the referring person or organization
A complaint to the Information and Privacy Commissioner for BC
An online post on social media and/or negative review about the care provider
A civil action
It is entirely possible for a single dispute to give rise to any or all of these possible routes. For any healthcare provider, any one of these actions will be distressing. Several of them together can be paralyzing, demoralizing, depressing, and otherwise emotionally draining. This is before considering the possible regulatory penalties or monetary damages that may emerge from a substantiated complaint.
Most complaints emerge at first in the form of the client making an informal complaint in writing or in person. If that happens, move quickly to deal with the complaint informally, before the stakes get higher and the client’s position becomes more entrenched. At this early stage remember to READ the situation:
Remain calm;
Engage support;
Acknowledge the concern; and
Deescalate
Whether you get support internally from your manager, a senior staff member, or from a lawyer at this stage may depend on the severity of the complaint and your practice’s experience in dealing with them but remember that engaging a lawyer earlier rather than later is always a smart decision.
How do I resolve a complaint informally?
It may seem trite, but listening to and reflecting on the complaint is the first step to resolving it. If the complaint is made to you directly, there is often a chance for early resolution. How that will happen depends on the particular client, their wants and circumstances. Some clients seek a refund or discount on payment for services. Others will seek some kind of accommodation. And then, there are many that simply want to be heard.
Whatever their position, document (a) the client’s concern and (b) any remedy they appear to be seeking. Take these facts and take time to reflect and get advice on them. It’s possible that a client’s concern can only be resolved by action taken on your part, the concern is about a situation over which you have no control, or somewhere in between.
There are some immediate steps you can take to repair the relationship, depending on the nature of the complaint:
The concern is about a perceived mistake: you may offer an apology, some kind of remedial action, or simply acknowledge the concern;
The concern relates to a judgement call, or exercise of discretion you made: explain to the client your reasoning for the decision;
The concern relates to actions taken to comply with a legal or professional obligation: explain what the obligation was and why you had to make the decision you did.
It may be helpful to explore possible solutions with the client. For example, if a client takes issue with an observation or conclusion you documented, under no circumstances should you alter your documentation after the fact, but you can offer to make a note on their file indicating the client’s objection or contrary opinion to your conclusion.
Warning: do not apologize for something you did not do or for an action or a decision that you believe was correct. Doing so can be perceived as an acknowledgement of error on your part. You can be empathetic, or communicate you are sorry that something happened, but always remember to stop short of taking responsibility for something that did not occur or was not a genuine mistake.
I listened to the client, and it appears I genuinely made a mistake. What next?
If after hearing and reflecting on the initial complaint, you realize you made a bona fide error, you should consider what steps you can take to remedy that error. This is the point where you absolutely should seek advice before proceeding. You may have reporting obligations to your insurer, supervisor, and/or regulatory college. If the error involves a breach of privacy, for instance, you likely need to notify both the client and the Information and Privacy Commissioner.
As soon as you identify the mistake get advice from a lawyer. Contrary to what you see on TV, this won’t make you appear guilty, and in fact regulators and other decision makers view the engagement of counsel as your recognition of the seriousness of the concern, and further evidence of your professionalism in dealing with it proactively.
Warning: do not try to cover up the mistake or alter your records. Whatever consequences flow from the mistake, the consequences of trying to cover it up will be far worse than simply acknowledging the mistake and working towards a remedy with the assistance of a lawyer.
I’m a regulated professional. What should I expect if someone complains to my college?
If you are a regulated healthcare professional, frequently you will only learn about a client’s concerns through a notification from your regulatory college that they received a complaint about you. If that is the case, your first call should be to a lawyer, full stop. Even a minor complaint about normally appropriate conduct should not be responded to without advice. Depending on how a complaint is responded to, it can create further difficulties for a professional, such as if a records investigation reveals a concern that is not the subject of the complaint, or where the tone or content of the professional’s response causes further concern. A regulatory body often is obligated to investigate every complaint, no matter how frivolous.
Every regulatory college’s mandate (at least in theory) is to regulate the profession in the public interest and their overarching concern is public protection. The motivation of the client who made the complaint is not relevant and will not prevent a regulatory body from investigating or considering a complaint if it relates to potential misconduct. This also means that responding to a complaint by blaming the client will only reflect poorly on the professional. Criticizing the client may feel good and may even be justified, but it could result in the committee reviewing you in a negative light.
This is not to say that a strong response to a complaint, even one that points out the errors in the client’s account or their bad faith, is not sometimes warranted, but this type of response is often better communicated by legal counsel, who can bring outside perspective to the proceeding and moderate the content and tone of such a response with care and professionalism.
How can I be ready?
A complaint from a client will always be upsetting and notice of a complaint or investigation from a regulatory, insurer or payment provider can be devastating. Do not rush to respond, but nor should you sit paralyzed with fear. With expert assistance from an experienced lawyer at the outset, many complaints can be resolved at an early stage, and others can be addressed without serious consequences.
As a final takeaway, consider printing out this list of 6 Dos and 6 Don’ts” of actions you should (or shouldn’t) take when encountering a complaint and keeping it close at hand so you’re ready for when one occurs.
Dos:
Engage your lawyer as early as possible in the process;
Listen to your client’s concerns and try to resolve them informally;
Keep complete records and provide copies of to your lawyer;
For formal complaints through a regulated college, prepare a summary of your response;
Compile a list of everyone involved or with knowledge of the situation; and
Seek support for your stress and mental health.
Don’ts:
Discuss the situation with anyone but your supervisor, and once engaged, your lawyer;
Create notes or records after getting notice of a complaint (except as requested by your lawyer);
Provide more information or documentation than what the regulator has requested;
Contact the client directly while the regulatory process is engaged;
Forget about the client’s needs for ongoing service or treatment; and
Panic!
For further assistance in managing a client complaint or regulatory investigation, contact Teddy Weinstein at 778-405-2260