10 Ways To Protect Yourself From Patient Complaints

This entry is prompted by a recent question from one of my MOs. I believe we have quite a number of young doctors reading the blog, so I hope you will find this useful.

Administrators, consider yourself warned that you may find the following content 'disturbing'. :)


10. Avoid high-risk patients.

If you're wondering whether I can quote at least 1 randomized controlled trial, preferably triple-blinded, with p value less than 0.0000001, you are sadly mistaken.
Is there a one-size-fits-all high-risk profile? Probably not. Based on personal experience, we tend to develop our own sets of criteria, and with time, through trial and error, you will discover yours.

I know what mine are, but posting them on a public site may be construed by certain 'sensitive personalities' as an example of 'causing societal disharmony', if you catch my drift.

However, the one characteristic I would probably consider a universal precaution is any patient who's 'high-profile', or who has a relative who falls into that category, i.e. celebrities, political figures.

Also, I would be VERY wary of journalists. Don't give them something to write about!



9. Attend risk management workshops and apply what you learn.

This is low on the list for me, for a good reason.

During my rather lengthy career, I have attended a total of ONE such workshop, and I refuse to attend any more.

Why? Because days after learning a wonderful method - complete with a catchy pnemonic - of handling difficult patients / relatives, I managed a guy who couldn't give a rat's ass about my newly acquired skills. He was clearly malingering, blew his top when I refused to issue a medical cert, loudly declared he's 'a lawyer', that he would 'write to the Forum Page' about me, then stormed off to the administrative offices upstairs to lodge a complaint.

He didn't get the MC, and I didn't make any headlines in the newspaper. But don't expect me to bother with any of these workshops ever again, because they obviously don't work on PSYCHOS.

But if you need CME points, be my guest.



8. Spread the shit - oops, I mean blame - around.

What does this mean? Well, if you're still an ikan bilis, so to speak, you will have seniors available to act as buffers, i.e. to review and vet your cases, handle difficult patients / relatives, etc.

While my generation of doctors ( yes, I consider myself a little old ) used to tahan all sorts of nonsense and clinical catastrophes until just before we dropped dead, rather than consult a registrar or consultant, things couldn't be more different now.

My MOs drive me insane with their bizarre updates, which are completely separate from the medical management. I honestly don't care what time the relative is coming to bring the patient home, as long as the patient is fit for discharge, okay?

But this is truly a savvy move on the MO's part. They love to tell me they're discharging a case, after all the tests done are normal and the patient is super-well. Why are you consulting me then, I ask. The reply: Oh, I just wanted to let you know.

Took me a while to fully understand their strategy. If they document having 'consulted a senior', if a complaint materializes, you have to answer it, even if it isn't about you per se.

In fact, some MOs may escape the patient's / relative's wrath completely, if the latter somehow latch onto YOU for whatever reason, even though your interaction with them lasted less than 5 minutes.

Very smart indeed.


7. Look busy, even if you're not.

True story. a patient's email feedback was circulated around my department, in which the patient criticized everything from the waiting time to nursing issues. However, she reserved the highest praise for one of my MOs, for 'working so hard', just because he was observed to be 'running around while everyone else was taking their time'.

This is a direct quote.

Doesn't matter if this particular MO was one of the least productive we had ever had. Yes, he ran around a lot, often with a stressed / harrassed expression on his face, but mostly because he had no clue what he was doing, and failed miserably at multi-tasking.

But the most important lesson to learn here is: the patient / relative rely heavily on APPEARANCES. So make sure you look as busy as possible, because they don't know the difference!


6. Offer freebies.

If you run clinics, check the cabinets for free samples from pharamaceutical companies. Patients LOVE medications and vitamins they don't have to pay a single cent for, and these could come in very handy if you sense a complaint coming your way.

Just present the person with a couple of boxes and wait for the smile.

Never fails. :)


5. Market yourself.

One MO was famous for shamelessly bragging about his venepuncture skills, convincing patients that they had the worst venous access in the universe, and that he was the only doctor who could take their blood / set their IV cannulas on the first try.

As a result, he consistently received compliments from patients and relatives, for his 'exceptional care'.

But make sure you don't come across as obnoxious. This MO managed to pull it off, and I only wish I had learned from him before he finished the rotation, heh!


4. Flirt.

Yes, you read correctly.

Never underestimate the power of pheromones. This tactic can be a powerful tool, but of course, you gotta have skills, and know how to pick the right targets.

E.g. If you're a young male, the ideal patient who will be susceptible to your charms is a young female, and vice versa. Even those in the middle-aged group appreciate it when a young doctor showers them with attention.

One of my ex-MOs, a strappingly handsome Caucasian dude, was lazy and unpopular among his medical colleagues, but a huge hit with the patients, especially the young ladies.

Remember, a patient who's hot under the collar will never hurt you.


3. Give the patients whatever the hell they want.

See point #9.

Don't be stingy with MCs. Prescribe antibiotics if they demand it, even if it's clearly a viral infection. Why put yourself through hell when they won't listen to reason?


2. Be generous with your time.

This is guaranteed to please any patient / relative, because in Singapore, that is how a doctor's competence is measured.

Never mind if you spend 30 minutes talking about family, kids, travel, food and shopping. As long as they know it's a damn busy clinic / ward / A&E, they will LOVE you for giving them such VIP treatment.

Just ignore your poor colleagues who're working their butts off to clear the changes and patient queues. You see the bigger picture. Service quality awards are 10 times more impressive than actual clinical acumen, conscientiousness and efficiency!


1. Be extra nice! Bedside manner 99%, clinical skills 1%.

Aside from spending loads of time with the patient, always ask whether [ where applicable ] (a) s/he has had his/her breakfast / lunch / dinner yet, (b) you can get him/her a drink of water if s/he's thirsty, (c) you can get him/her some food if s/he's hungry, (d) you can get him/her an extra blanket if s/he's feeling cold... you get the idea.

Sayang the patient - preferably in front of relatives - as much as possible. A reassuring hand on the shoulder or arm. A sympathetic smile. A kind word. Never interrupt. Nod your head repeatedly, even if you're thinking about that nice sports car you want to buy, or that date you have this evening. Unless you're treating a professional magician who's telepathic, you're safe.

Because Harold Shipman, the infamous doctor/serial killer, was so beloved by his patients and their families, that even when his horrific crimes were made public, remained exalted by many.

In fact, one of the victims' sons remarked that were his mother still alive, he would want Dr. Shipman ( her killer ) to remain their family physician!


Let that be a valuable lesson to you all.

Here endeth the tutorial.