Treat complaints with the respect they deserve
There’s nothing more likely to generate another complaint than stressing about the first one, losing focus and making another mistake
I’ve got a complaint about complaints. Why do we get so little training in dealing with them? I think there’s a lot to learn from and about them. Indemnity providers are very helpful and, while I’ve found a little variation in the level of help they provide, I do think they are very knowledgeable and a great source of reassurance. They may not agree entirely with the following take on complaints.
I’m not talking about the kind of thing that gets you in front of a judge. That level of ‘complaint’ is far from the norm and is almost always the result of an individual’s deliberate actions which are neither professional nor decent within society. Fraud, assaults and violence of any type should never be accepted in society at large, let alone a profession which should hold itself to a higher standard.
I’m talking about the kind of complaints that come up frequently and, in today’s litigious and social media savvy society, are a huge blow to the confidence and a stimulus for calamitous anxiety in a profession that’s already hard enough to navigate. It’s the little things, unintentional consequences of procedures, lab work, ill-advised planning, circumstance and misfortune. Very rarely are these things deliberate. Very often, they are avoidable.
We try hard to mitigate risk, reduce our patient’s pain and discomfort and try to be pleasant and caring all the time. This is hard and yet often isn’t the best plan. Some pointed communication of the grim reality is what people should hear to give them perspective on the difficulties they are about to have. However, we have to temper that reality with gaining consent for and compliance with those procedures. “I only ever do small fillings and easy extractions” is not the best tactic to avoid complaints, but it gets easy consent.
We must strike the balance of reassuring a patient, while ensuring they understand procedures are difficult. They are often successful yet have elements of risk. Everyone hears: “Investments can go up and down” and: “Your home may be at risk if you do not keep up repayments”. No one believes that’s meant for them. They think everything will be fine but get dreadfully upset when their ‘Crypto.crap’ investment falters.
Unfortunately, we believe healthcare can cure everything with a pill (obviously a small one that’s easy to swallow, it doesn’t matter if you forget to take one or two or finish the course “because we had a weekend away booked”). That pill has no side-effects, and all surgical processes are successful, painless and don’t require weeks of rehab. The same is true of dentistry: RCT is never painful, extractions heal in five minutes, and we can all go to the pub afterwards.
Fundamentally, we are to blame when our communication falls short. Most often, that’s where the problem starts. We don’t give the full story. We couch our answers or fail to achieve proper consent in the first instance by listing a range of risks but not really getting a good understanding of what is likely to happen to that individual. What we really fail to do is understand others’ levels of competence, listening ability or understanding. It’s taken me decades to learn how to do this. I believe the teaching of complaint prevention isn’t at the level we need.
The second thing that often causes problems is our inability or unwillingness to recognise when it’s going, or gone, wrong and how to dig yourself out of the s***. The sooner your instincts are tuned into this one, the easier life will be.
Someone comes in: buccal cusp fractured, and you fill it back up. “That’ll be fine…” Back the next week: it’s failed. Change the material and charge again. “That’ll be fine…” Back in two weeks: failed again. You’ll need a crown/inlay. “That’ll be fine…” – and it probably will but the patient has lost confidence, has paid for three restorations and is contemplating another dentist. If you’d said in the first instance that the fill could last years and is the cheap, simple option but if there’s a failure, an indirect restoration is the next step, then you’d be fine. The trick is maintaining that level of awareness, risk assessment and communication with patients in every scenario.
When you do get a complaint, treat it with the respect it deserves. Try to deal with it conclusively, in as few stages as possible. Pride: forget it. Even if you believe you’ve done your greatest work ever, someone else will argue it’s not right. The time, effort and stress of dealing with it weighs heavily until things are resolved.
Deal with the patient yourself, if at all possible. It’s uncomfortable but demonstrates that you care. Write the letter yourself, with some tweaks from your indemnity provider; don’t use AI. It demonstrates you care. Dip into your pocket and pay for something new or offer a free treatment. It shows you care. Maybe you don’t care, but it suggests you do.
What you will care about is when the patient gets solicitors, the GDC and the Ombudsman involved because they don’t think you’re bothered. That’s when the stress levels are extraordinary. Often, because you haven’t said sorry.
Learn to swallow your professional pride, be uncomfortable, show humility and apologise. Sincerely. Genuinely try to resolve it: fix the problem or find another solution. As simply and quickly as possible before that snowball gathers momentum and affects your professional and personal life and well-being.
There’s nothing more likely to generate another complaint than stressing about the first one, losing focus and making another mistake.
Arthur Dent is a practising NHS dentist in Scotland. If you have a comment or question for Arthur? Email arthurdent@sdmag.co.uk