People are more confident and better-practised at complaining than ever before. Whether the complaint relates to slow service in a restaurant or the supply of faulty goods, we seem more willing to express our displeasure and to seek a remedy. Dental patients are no exception. Each year brings a rise in the number of complaints received about dentists and their practices.
Although it may be an unpleasant thought, it is increasingly likely that at some stage in the future a letter of complaint will drop through your surgery letterbox. Nobody is perfect; but even perfection in your clinical dentistry is no guarantee that your patients will not complain about some aspect of their overall experience under your care. However, there are ways to reduce the risks and to limit the damage when that unwanted letter arrives.
What is a complaint and how are they made?
Dental Councils and Boards refer to complaints as any written or spoken expression of dissatisfaction by a patient about a dental service or treatment, whether justified or not. Just as the number of complaints increase so do the number of ways that patients choose to make them. Remember - your patients always have a right to complain, whatever the terms of how the service is delivered or paid for.
Patients may complain directly to you or your practice. Familiarise yourself with your practice's complaints procedure and ensure that it is followed.
If the complaint cannot be resolved at a local level, a patient may wish to escalate their complaint to others, such as formal complaint mechanisms e.g AHPRA in Australia, HRANZ in New Zealnd or the Regulatory body such as the Health Board. Escalation of a complaint caused distress and anxiety whatever the final outcome and it is usually in the dentist's best interests if the matter can be resolved in-house.
Why do complaints arise?
Many of the complaints that we see arise because of a breakdown of communication between the dentist and the patient and can be traced back to the misunderstandings that result fro m that. To minimise the likelihood of a complaint arising in the first place it is helpful to identify the areas that are most likely to lead to patient dissatisfaction.Â
Putting aside matters of clinical care, experience suggests the following as the top five areas of complaint in relation to private treatment:
- Pain
- Fees
- Conduct (including rudeness)
- Access (or lack of access) to treatment
- Lack of Consent
Other concerns that related to Hospital and Government services included:
Quality of care
- Cost of treatment or the way costs are determined
- Patients' removal from practice lists
- Poor communication
- Dentist availability
How to avoid complaints
It goes without saying that offering a consistently high quality of clinical care, is the best way to avoid clinical complaints. However, the following pointers, which are by no means exhaustive, will also help reduce the likelihood of patient dissatisfaction.
Good communication
Try to establish a good rapport with each patient, by spending time and effort in getting to know them. Ensuring that your patients understand what you are telling them about their treatment is one of the best ways to avoid a complaint. Explain everything to your patients in straightforward terms and provide as much detail as possible. Ask questions to make sure they understand the advice you have given, allowing the patient to be in a position to make an informed choice about their treatment. When treating children, before you begin any treatment, ensure that their parent or guardian consents and is as informed as they would be if you were treating them, rather than the child.
Clear treatment plans and fees
Time and time again, dentists face criticism because they had not given the patient a clear treatment plan and details of proposed fees. Ensure that you provide written treatment plans setting out the cost of each part of the proposed treatment as well as other treatment options and provide your treatment plans in advance of the treatment itself. Allow your patients time to consider these and come back with any questions. Make sure your patient knows their payment status. If you are seeing a patient on behalf of a colleague or are taking them over from a previous practitioner, never assume their consent to treatment on the basis of previous notes; always ask.
Create good records
Ensure that you make clear, legible notes, documenting your advice and treatment. Records are essential in your defence in the event of a complaint or worse still, a referral to an investigation or civil claim. Complaints, particularly in the form of litigation or investigations may occur many months and even years after the treatment was undertaken and so the notes are the only way that you can recall what was said and done. Your memory can play tricks on you, but good contemporaneous notes can come to your rescue.
If you still receive a complaint, what next?
Even the most careful dentists make mistakes. In the event that you do receive a complaint, do not ignore it! Respond to all complaints in a measured and timely way. Discuss the complaint with a colleague, who will doubtless have had a similar experience and seek professional advice before you respond to the complaint.
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