ETHICS

 

Mastering patient complaints: Effective strategies for dental practices

 

 

Dr Jacobus Barnard^I; Dr Tinesha Parbhoo^II

^IBChD (UP), MFGDP (UK), PDD (Impl.), PDD (CS) - Dental Mediator at SADA
^IIBChD (Up) - Head: Clinical Support at SADA

 

 

Patient complaints are an inevitable aspect of delivering healthcare services, representing critical feedback that can highlight areas needing improvement and opportunities for enhancing patient satisfaction.

Effective handling of these complaints is essential not only for maintaining a positive patient-practitioner relationship but also for ensuring compliance with professional and ethical standards. This article explores the nature of patient complaints within dental practices, emphasising the importance of proactive and empathetic communication, and outlines best practices for resolving issues efficiently and constructively.

By implementing a structured and responsive complaints management procedure, healthcare providers can address patient concerns promptly, prevent escalation to third-party involvement, and ultimately improve the quality of care provided.

Since introducing an independent complaints resolution service in 2012, SADA has successfully resolved more than 5500 disputes between patients and dentists, offering an alternative to the HPCSA for patients seeking redress for their dental care concerns. This series aims to share the valuable experience gained over the past 12 years, assisting our members in preventing patient complaints.

I have received a patient complaint - what now?

As with any professional service, there may be times when outcomes do not meet expectations, leading to patient complaints. Patients dissatisfied with their dental treatment or its cost often initially communicate their concerns and expectations to the dentist or practice staff, either verbally or in writing. It is only when the practice is unable or unwilling to address these concerns that patients may involve a third party, such as the South African Dental Association (SADA) or the Health Professions Council of South Africa (HPCSA). Many complaints received by SADA or HPCSA could have been resolved internally through an effective practice complaint procedure. Patients who direct their complaints to the HPCSA may sometimes be disappointed by the lengthy process and lack of a satisfactory resolution, which often involves simply receiving an explanation or an apology. In a dental setting, the most effective way to address a patient's concerns is for the dentist to invite the patient to discuss their issues at the earliest possible stage. If the dentist is unaware of the patient's dissatisfaction, resolving the issue is impossible. To encourage patients to voice any problems, they need confidence that their concerns will be listened to and addressed promptly and effectively.

Do's and don'ts when you receive a complaint

Do not: Tell the patient they are wrong, unreasonable or that no one else has ever complained.

Do: Acknowledge the patient's unhappiness and take them seriously. Listen to their experience, concerns and expectations without interrupting. If the practice does not listen, the patient will seek a willing ear, such as SADA, the HPCSA or a lawyer.

Do: Give the patient the time and recognition to explore their complaint as thoroughly or superficially as they wish. Ensure they do not feel their complaint is being ignored or dismissed.

An effective complaints procedure can prevent unnecessary third-party involvement and provide a basis for the dentist and patient to rebuild their relationship. However, an in-house complaints procedure is not intended to resolve issues of liability, negligence, financial or other compensation, or regulatory complaints. In these instances, dentists must contact their indemnifier urgently for advice and assistance.

Complaints are an unfortunate reality for anyone delivering professional services. As healthcare professionals, we have an ethical and professional duty to respond to criticism and complaints promptly and constructively (HPCSA Booklet 1- General Ethical Guidelines - 5.1.10 Duties to Patients). On the other hand, our patients have the right to complain about healthcare services received, to have such complaints investigated, and to receive a full response (Patients Right Charter - Booklet 3 - 2.12 Complaints about health services).

The importance of implementing a "practice complaints procedure" at the practice for patients who want to complain about their treatment or experience cannot be overestimated. Most complaints received by the HPCSA or SADA could have been resolved in-house through a practice complaints procedure. It is only because unhappy patients are ignored or dismissed at the practice that the decision to involve a third party is made.

Principles of a practice complaints procedure

Every staff member must be trained in what to do when a patient expresses dissatisfaction and each plays a vital role in reducing the likelihood of a patient becoming dissatisfied. An effective complaints procedure can prevent unnecessary third-party involvement and provide a basis for a dentist and patient to rebuild their relationship.

Written procedure: An agreed written procedure for handling complaints ensures every staff member knows what to do.

Designated individual: A named senior individual with good communication skills and experience should be responsible for operating the practice's in-house complaints procedures. Patients should be advised of this person's name, job title and how to contact them, and assured of a friendly, approachable and prompt response.

Acknowledgment and logging: Every complaint must be listened to, acknowledged and logged in a register, even if the dentist or staff member thinks the complaint has no merit. Often, the first time a dentist becomes aware of a complaint is when the letter from the HPCSA arrives because staff did not inform the dentist of the patient's complaint as soon as it was received.

Patient choices: Give the patient options - would they prefer to meet at the practice or discuss their concerns over the telephone?

Communication: Always keep the patient informed of what is happening. A person who feels their complaint is ignored is more likely to involve a third party such as SADA or the HPCSA. Confirming each stage of the complaints procedure in writing is a good policy. If the patient involves the HPCSA or a lawyer, it is invaluable to be able to demonstrate that you did everything you could to resolve the problem at an early stage.

Efficient resolution: Customer satisfaction decreases in proportion to the number of times the complainant has to contact the organisation to effect resolution. Make each contact count.

Training: Good communicators usually make good complaints handlers. Most dental team members have no formal communication or complaint-handling training, so it is worthwhile to train them in these skills

Learning from international best practices

UK: The General Dental Council (GDC) in the UK emphasises the importance of clear communication and a structured complaints process. The GDC recommends having a designated complaints manager, offering patients multiple ways to submit their complaints, and ensuring timely and transparent responses.

US: The American Dental Association (ADA) suggests that practices adopt a patient-centric approach to complaints, involving patients in the resolution process and using feedback to drive continuous improvement. They also recommend regular training for staff on handling difficult conversations and conflict resolution.

Australia: The Australian Dental Association (ADA) highlights the importance of cultural competence in handling complaints, recognising that communication styles and expectations can vary significantly among different patient demographics. They advocate for personalised communication strategies to effectively address concerns.

Canada: The Canadian Dental Association (CDA) supports the use of mediation and alternative dispute resolution techniques to handle complaints. This approach aims to resolve issues without escalating to regulatory bodies, maintaining a focus on restoring patient relationships and trust.

Maintaining ethical standards: Duties and rights

Healthcare professionals have a duty to respond to complaints constructively, while patients have the right to have their concerns investigated and addressed. Adhering to ethical guidelines and implementing effective complaints procedures can help balance these duties and rights, ensuring a positive outcome for both parties.

Conclusion

Patient complaints, while challenging, provide an opportunity for improvement in dental practices. By adopting proactive communication strategies, implementing a robust complaints procedure and continuously training staff, dental practices can effectively address patient concerns, prevent escalation to third-party involvement and enhance the overall quality of care. Embracing these strategies not only improves patient satisfaction but also strengthens the patient-practitioner relationship, contributing to the long-term success of the practice.

NB: The following edition of this article will focus on how to respond to a patient complaint as well as useful communication skills to employ when dealing with a patient.