In your words

The psychological repercussions of patient complaints

There needs to be a better way to protect patients and support physicians.

Editor’s note: This story was originally published on KevinMD and is republished here with permission. It has been edited for The DO. This is an opinion piece; the views expressed are the author’s own and do not necessarily represent the views of The DO or the AOA.

In any industry, there will always be unhappy customers. Having a formalized method of dealing with complaints is absolutely necessary to protect consumers and patients. What isn’t discussed enough is the severity of these complaints’ psychological repercussions on physicians and other medical providers.

Most providers spend years of their lives in school, sacrificing family plans, social events, and sometimes their own well-being, all on a mission to care for others. Despite our training and best intentions, there will be cases that lack the desired outcome.

For people working in most other fields, a complaint about services or outcomes may indicate a need to review what steps went wrong or could’ve gone better, but in medicine, complaints from patients cause distress about the providers’ knowledge and ability to continue practicing in the field.

Lack of support

There is a difference between malpractice, an undesired outcome, and a poor patient experience. Lack of support from hospital administration can exacerbate a provider’s insecurity and anxiety and even contribute to suicidal ideation.

The balancing act of patient advocacy and preserving physician integrity is delicate and by no means simple.

When hospitals or private physician groups routinely write off patient balances for frivolous reasons as a means to appease angry patients, or worse, angry family members, they are saying it’s OK to abuse the benevolence of health care providers. It detracts from the value of the care a provider spent years achieving through school and residency.

Health care’s fear of litigation is contributing to physician shortages, as doctors do not want to practice in locations where they feel undermined by their employer.

A lack of emotional/psychological support prevents many physicians from coping in a healthy way with patient complaints, grievances, and lawsuits. These stressors can contribute to sleepless nights, anxiety, depression and physician desires to leave clinical practice.

Searching for a better way

There needs to be a better way to protect patients and support physicians.

The commercialization of medicine has benefitted some, but without healthy doctors to provide care, the future of medicine might look very different. Patients talking to computer algorithms to obtain a diagnosis, prescription or referral may become the norm.

Artificial intelligence won’t have a conversation with you, though it will ask you numerous questions to fit you into a specific profile. It won’t palpate your abdomen or do a neurologic exam, but you may get a fancy watch to track your vital signs.

There is an art to medicine. Hands-on patient encounters foster a psychological connection between the patient and the clinician. There are nuances AI may take decades to compete with.

A deeper dive

For now, in my lifetime, I hope that people examine patients, and when there are questions about the quality of care, institutions perform a deeper dive into the real problem. (Was it the overall experience, a poor relationship with the doctor, financial stress that would be assumed by paying the medical bill, or actual malpractice?)

Without support from our employers, physicians will continue to feel the accumulation of burnout and insecurity that leads to emotional duress, leaving medical practice or the worst outcome: physician suicide.

We are not machines. The burden cost is evident, but when will the medical community, investors, and hospital administrators begin to truly support physicians and prevent these terrible outcomes?

Related reading:

Doing good in the world as a medical student

How autoimmune disorders almost derailed my medical training

2 comments

  1. No mention was made of medical boards who do not deal with malpractice but often are the first to get a patient complaint. Boards are notorious for using procedures that are very unlike the best of our justice system. Basically physicians are forced to defend themselves as if the patient’s concerns are true rather than the patient’s concerns must be proven. This is a bigger stress on physicians than often the complaint itself. Complaints are on paper and responses are on paper in most situations. Physicians do not face their accuser/complainer as occurs in the legal system, instead there is the requirement for the physician to defend themselves based on a complaint on paper, to respond on paper, and then without facing PEOPLE on a board, most often the physician hears back from the “names on the board” on paper. Where in this process is there any real concern for the doctor OR the patient? The patient is left to wonder what impact if any their complaint had and the doctor either is informed on paper the decision made by a medical board consisting of some individuals who may have been clinical physicians, some business persons, and some others in the community. How does any of this process serve to protect the doctor and patient and evoke fair and knowledgeable board decisions? If we are going to finally talk about patient complaints, we must address medical boards who could work to reduce emotional and psychological stress rather than add to it. Health and well being matter.

  2. As both a physician and a family member of a patient who was violated, injured, harmed and left alone in the ICU without orders with absolutely no physician attendance, I see a big problem for patients who are victims of this profit-driven, rushed-physician, and lower-level attended medical care. What I witnessed was appalling! If I would not have been there, my family member would have been seriously neurologically impaired or would have died. As it was, he entered perfectly healthy, but ended up labeled by physicians, suffered a TBI and a fractured spine, all because the healthy young patient was so trusting that the physicians, NPs and nurses were “trustworthy and professional”. What are patients to do?? It is almost impossible to sue, which does nothing to change the profit-driven medical system that is owned by the insurance companies. Physicians trickle down anger toward the patients because they are treated as non-professional employees who are no longer allowed to use cognition to interact and treat patients. Too bad for those who suffer on either end! As long as physicians continue to be at the mercy of insurance co/hospital systems who are immune to ANY policing ($$$$), and patients are made to feel shame and blame for medical conditions (why are we punished for having cancer and treated like bums??), things will only get worse! There is very little help for those of us who are victims of this corrupt and unsafe system we call medical care.

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