In this article we reflect and learn from cases where, whilst difficult, the complaint process has been navigated smoothly... right up until it wasn’t, and seek learnings from others’ missteps, in what not to do, when managing a patient complaint.

The case 

Dr X was an orthodontist who had been operating his own practice for the last 15 years. Dr X’s practice was spread across a number of locations, across quite a large regional area, requiring significant travel for him and his OHT’s.  

Mrs P attended the practice with her daughter, Miss Q, to get an opinion on the options available for her for fixed braces. While Miss Q’s case was quite complex, due to their location and financial constraints, Mrs P and Miss Q elected to proceed with a non-surgical camouflage option, to address the main areas of aesthetic concern to Miss Q. 

The treatment commenced and was proceeding uneventfully, and as is often the case, Mrs P took up the option of an in-house payment plan with the practice spread over the course of the expected treatment time. 

Unfortunately, 12 months in and nearing the end of the treatment plan, Mrs P and Miss Q came to realise that they were not happy with how the treatment had progressed and the current alignment, expressing concern on what was potentially going to be the end result. 

With this in mind, Mrs P contacted the practice to outline her concerns and arrange an appointment with Dr X to discuss her dissatisfaction and come up with a plan on the next steps.  

Unfortunately, Miss Q was unwell at the time her appointment was scheduled and she was unable to attend. Additionally, due to Dr X's travel around the many locations, there was some significant delay in rescheduling a face-to-face consultation with him to determine where the treatment was up to and what the available next steps were.

While Mrs P and Dr X were communicating to arrange an appropriate time, Mrs P had not proceeded with her monthly payment transfers, considering that the treatment was on hold, which Dr X was aware of and happy to leave at that time.

Despite the delays in arranging a follow up appointment to discuss Mrs P’s concerns face-to-face, things had been progressing smoothly with Dr X and Mrs P's communication together, with both happy to work towards a resolution. Regretfully however, the practices accounting staff were not aware of the situation, and they noted the discrepancy of the missed payments. 

The practice accounts department followed up with Mrs P after the first failed payment. Mrs P did not respond to this email, assuming this was a standard practice email sent accidentally, as Dr X was aware that treatment was on hold.

Having received no communication back, when the third payment was subsequently missed, the accounts department decided to take proactive steps and promptly sent the overdue account to be dealt with by the debt collection company the practice engaged when required.

As you can imagine, when Mrs P received communication by the third-party regarding the outstanding account, the open and positive communication between Mrs P and Dr X suffered a major blow, and rapidly unravelled, with Mrs P feeling blindsided. Dr X desperately tried to reel the situation in once he had found out what had occurred, though unfortunately the damage had already been done. Mrs P promptly took Miss Q to another specialist practice for a second opinion and formalised her complaint to The Office of the Health Ombudsman, resulting in a notification to the practitioner to engage in a local resolution process. 

On receipt of the OHO notification, Dr X realised that they had lost control of the narrative and reached out to Dental Protection for assistance with formulation of their submission.  

Learning points 

• While all practitioners aim to not have to deal with receiving complaints, unfortunately there are few who will ever achieve this ideal. With this in mind, it is important that each practice has a well thought out complaints policy. Additionally, it is imperative that each member of staff know how to navigate this, and their part in this process.

• Unfortunately, whilst Dr X’s practice did have a complaints policy and Mrs P's concerns had been escalated accordingly, they had failed to consider the accounts department protocol on ‘bad debts’. Consequently, this lack of communication inadvertently tipped what was a positive complaints experience, over the edge, and resulted in an incredibly disgruntled patient mother, refusing to engage further.