Exercise great caution in responding to patient’s angry letter

Question: I am the risk manager for a large acute care hospital and several affiliated clinics. With the number of patients we see, it is not uncommon to receive a letter of complaint regarding the way a patient was treated. If the patient alleges actual malpractice, I know how to proceed. But what if the patient is only alleging that our staff was rude or insensitive?

Answer: This issue was addressed recently by Debra McBride, RN, JD, assistant vice president for risk management at Midwest Medical Insurance Company in Edina, MN. She spoke at the recent meeting of the American Society for Healthcare Risk Management in San Diego, addressing several topics regarding dissatisfied patients. The following is her advice concerning angry letters.

First, she cautions you not to be quick to rule out the likelihood of a malpractice lawsuit. In fact, the way you handle the letter may determine whether the patient follows with a malpractice claim. McBride points out that whenever a patient is angry enough to write a letter to you voicing those complaints, some response is necessary. Failing to respond quickly and adequately can spur a lawsuit.

Plaintiffs often report that "filing a lawsuit was the only way to get their attention," so you need to make sure the patient feels that you heard the complaint and are taking it seriously. A personal response is necessary, not anything resembling a form letter or a generic acknowledgment that the letter was received. McBride suggests keeping these things in mind when composing the response letter:

• Avoid any admission of liability.

• Do not blame others for the problem.

• Keep your answer fairly simple. An overly complicated answer can inflame the patient’s anger because, regardless of the content, it may suggest you are denying the problem.

• If the patient asked any questions in the complaint letter, answer them as clearly and simply as you can.

• If the patient’s questions cannot be answered, be honest in saying the answer is beyond your knowledge.

• Avoid medical jargon.

• If it seems the letter was intended solely to vent frustration and anger, say that you understand the patient’s frustration and anger. Offer to discuss the patient’s concerns at a convenient time.

Source: Debra McBride, assistant vice president for risk management, MMIC, 6600 France Avenue South, No. 245, Edina MN 55435. Telephone: (612) 922-5445. E-mail: