How Formal Patient Complaints Are Processed

An older patient complaining to her doctor

Sturti / E+ / Getty Images

A patient may see no other option but to file a complaint against a healthcare worker. It may be against a registered nurse, dentist, chiropractor, therapist, surgeon, or family doctor. When a patient files a complaint against a healthcare worker, there are certain steps they should follow. They set in motion a process at the agency where they made the complaint. It is important for both the healthcare professional as well as the patient to be aware of what may occur after the complaint is formally lodged.

Complaints Against Healthcare Professionals

2The Department of Health provides four categories in which a patient can make a complaint against a healthcare worker. The four categories are as follows:

  • General Health Care Professionals
  • Dental Professionals
  • Psychiatric Professionals
  • Unlicensed Professionals

Each of these categories has a different process, and the results will vary according to which professional the complaint is being filed against.

According to the Department of Health, if the department determines that a patient complaint is a possible violation of state law, it will be investigated. A state department investigator may contact the patient for additional information. Following the legal review, the Department of Health will refer the complaint to the appropriate panel of the regulatory board to determine if a violation of state law exists. This matter can be lengthy, and it may be months before any suggestions and any results are determined on the patient’s case.

How Patients Can File a Complaint Against a Healthcare Professional

When filling out the complaint form, a patient should be aware of a few important factors.

  1. Make sure that the complaint letter is sent certified mail through the United States Postal Services.
  2. Make sure the complaint form is very specific in detail and contains as much evidence as possible. This will help to inform the individual who is viewing the complaint of exactly what is going on.
  3. Make sure that all details are given so that the case cannot be dismissed for lack of evidence. The majority of all complaint denials are due to a lack of evidence presented.

A patient may wonder, when is it necessary to make a complaint against a doctor? The answer to this question is simple. The patient can make a complaint at any point in time in which he or she has been mistreated, misdiagnosed and/or improperly treated by a doctor or other health care professional. As stated previously, make the complaint as soon as possible, be very detailed in the complaint and make available as much evidence that relates to the claim as possible.

Complaints of Negligence by a Physician

After the complaint is filed, it may be possible that the doctor is responsible for criminal liability. The charge would most likely be criminal negligence on a patient. Criminal negligence can be defined as acting without logical reason meanwhile creating a risk of injury, or death, upon another individual.

After finding confirmation that the accused doctor is possibly responsible for criminal patient negligence, the process can become very complicated and may take a long amount of time before a final decision is determined.

Another key factor is that lawyers are hesitant to take on such cases because he or she may not make much money off of the case when it is hard to prove patient criminal negligence. It is very hard to prove that a doctor has committed negligence and the case can be seen as accidental in which there may be no consequences at all.

Another consideration is whether or not the doctor has malpractice insurance. A doctor can choose to settle out of court in order to avoid a lengthy legal process, or take a chance at losing his, and or her, license(s).

Was this page helpful?