How to File a Complaint About a Doctor

Ensuring Your Grievance Is Heard and Acted Upon

Doctors, like anyone, are human who can make mistakes. The grievances can range from inappropriate or unethical behavior to medical errors that can cause serious harm or even death.

When faced with a wrongdoing for which you believe your doctor is to blame, there are avenues you can take to file a complaint. You may not always get the satisfaction you want, and it's possible you may never even get a reply. But does this mean you shouldn't act?

Particularly with government offices or state certification boards, every complaint will be recorded even if it is not deemed actionable. However, if multiple complaints are received and a pattern of behavior is established, there is a far better chance that an investigation will be pursued.

This is why it is important to lodge a complaint even if you never receive the satisfaction you had hoped for. By evidencing inappropriate, illegal, or harmful behavior, you can ensure the problem you experienced won't be shared by others.

Here are some tips and insights that may help:

Where to Lodge a Complaint

Pensive businesswoman looking away in conference room
Caiaimage/John Wildgoose/Getty Images

The first step to taking action is to identify what you hope to achieve. This requires you to look at the matter objectively and assess just how egregious the behavior or event actually was.

For the purpose of a complaint, you would need to establish what harm was done and what type of action would be appropriate to right that wrong.

The examples of this are many but can be broadly described as follows:

  • If you were insulted by a doctor, then you have every right to air your grievance. But would you call the state medical board about this? Probably not. In this instance, the appropriate action may be to write an online review detailing the incident or to confront the doctor directly if you haven't done so yet.
  • On the other hand, if the insult or behavior was directed at you because of race, gender, sexual orientation, age, or religion, there are civil actions you can take, including contacting the Office for Civil Rights at the U.S. Department of Health and Human Services.
  • If you experienced a consumer-related problem, such as overbilling or the non-delivery of services, then a medical board would be unlikely to help. For this, there are consumer protection agencies you can turn to that usually fall under the state attorney general's office.
  • On the other hand, if there have been illegal or unethical billing practices (including fraudulent billing, upcoding, and balance billing), then it is important to report the matter to both the state attorney general's office and the state department of insurance.
  • Finally, if a medical error resulted in personal injury, hospitalization, disability, the loss of quality of life, or death, then it is important to report the matter to the state medical board, the state department of health, and the professional certification board specific to the doctor's practice. You will need to do so with an attorney if you are seeking damages or planning to litigate.

How to Lodge a Complaint

Close-up of hands writing on laptop
Klaus Vedfelt /Getty Images

Many government and institutional authorities allow you to file a complaint directly on their websites. For others, you may need to write a letter. In either case, there are guidelines you should follow to improve your chances of getting a reply:

  • Keep your letter concise. The content should be no more than a few paragraphs, ideally written in short sentences on a single page. Be specific about your complaints, using a bulleted list, if needed, to punctuate your points.
  • Remain objective. Tell what happened as simply as possible rather than describing how you felt. The point is to highlight the inappropriate behavior, not your response to it.
  • Tell what action you would like to be taken. In the end, if you don't know what that action should be, then is probably not actionable. If you are reasonable in your reply and expectations, then your complaint is more likely to be taken seriously.
  • Get help if you are unable to express yourself. If you have trouble communicating what happened or what you want, ask a family member to help or consider hiring a patient advocate experienced in these matters.

Finally, don't go in assuming that your efforts will be for naught. According to the Office for Civil Rights, for instance, of the 165,710 complaints received to September 2017, no less than 97 percent have been investigated and resolved.

If your complaint is appropriate and appropriately directed, the chances are good that it will be heard.

Was this page helpful?
Article Sources
  • Office for Civil Rights: U.S. Department of Health and Human Services. "Numbers at a Glance." Washington, D.C.; updated September 30, 2017.