Patient complaints can help practices improve

Fixing problems means going extra mile

Most private practices and hospitals make patients happy most of the time. But how the complaints are handled may be one of your most important customer service decisions.

After all, patients rarely notice when everything goes right — when they don’t wait long, the physician answers their questions, they hear about the lab results, and their bills are correct. But fixing what went wrong can determine whether they will vilify or extol your practice, says Kevin Sullivan, partner with Sullivan/ Luallin, a health care marketing and management consulting firm in San Diego.

"When things go wrong and people knock themselves out to set them right, that’s what sends us back to our neighborhood singing [the group’s] praises," says Sullivan.

Providers must track, resolve complaints

All medical groups need a system for reporting, tracking, and resolving complaints, he says, because even the practice with the best record for customer service and the most competent physicians will occasionally err.

Mistakes stem not only from sheer humanity but from the stresses of modern medical care. Practices face lean staffing, limited resources, and an unpredictable and sometimes overburdened workload — such as the rash of sick patients as a new epidemic works through the community or the doctor who must suddenly leave because of an emergency.

Patient expectations also vary. Some want to move in and out as quickly as possible; others want more TLC and conversation with the physician. The key, says Sullivan, lies in your immediate reaction. When you have a patient complaint, "It’s got to get to somebody whose job it is to find out what’s wrong and set it right," he says. In a small practice, that could be someone who is trained and handles the function as just a part of the normal duties, he says.

At Milwaukee Medical Clinic-Advanced Healthcare, that point-person is Marilyn Zanowski, quality assessment coordinator and patient advocate.

An employee who receives a complaint first apologizes to the patient for the dissatisfaction and promises that the concerns will be passed on to the practice administration. The employee fills out a quality assurance form detailing the incident and passes it on to Zanowski, who immediately sends out a card telling the patient she is investigating the complaint. (See sample of form, p. 30)

The patient eventually receives a letter that explains or resolves the issue. If it involves physician care, the physician drafts the letter, which is reviewed by administrators. "We try to get these things resolved in a matter of days if not in a day or two — as quickly as possible," says Julie Pedretti, director of marketing. "Patients appreciate the timely response."

In many cases, the complaint can be handled even more quickly and informally by the department supervisor while the patient is still in the office. Zanowski also tracks those informal complaints.

The clinic tries to ensure employees don’t further annoy patients by passing them along from one staff member to another. "If a patient is complaining to someone, the last thing he or she wants to do is tell the story all over again," Zanowski says. (For more information about educating staff on handling complaints, see p. 29.)

If patients call on the phone about a prior visit, Zanowski takes the complaint. And she’s available — by pager — to step in any time an employee or physician needs help handling an issue.

On occasion, patients may call after they receive their bills and say they believe the charges are too high for the care they received, Zanowski says. The physician and medical director will review the chart for appropriateness of care. If the patient has a long-term relationship with the practice, they may decide to provide a one-time discount in the interest of maintaining that loyalty.

You can’t please everyone

But the patient isn’t always right. And as the saying goes, you can’t please everybody all the time. Sometimes, after Zanowski and others have handled a complaint, patients will write that they are still dissatisfied. Yet Zanowski also has received thank-you notes for her efforts.

More importantly, the complaints help Zanowski identify weaknesses in the practice. "If we have patients complaining a lot about prolonged waits, it tells us we need more physicians in that area or we need better communication with our patients," she says.

Three years ago, Zanowski began notifying physicians about how many complaints had been received from their patients and how they compared with the practice average. Since then, the total number of complaints has declined, she says.

Responding promptly, efficiently, and graciously to complaints will pay off for practices like Milwaukee Medical Clinic, says Sullivan. Because of the small numbers involved, your efforts may not show up directly in patient satisfaction surveys. It’s a matter of values and attitudes. "[Staff in] practices that think and behave this way over time generate tremendous patient loyalty," he says.