how to report patient mistreatment from a doctor's office

by Trudie Crooks 9 min read

Filing complaints about a doctor, hospital, or provider

29 hours ago How to Report Mistreatment. There are many options available to you if you experience or witness mistreatment. If you are unsure whether a behavior rises to the level of mistreatment, you are encouraged to contact Diana Martínez, Director of the Learning Environment Office (confidential reporter), at 505.272.7861 or deemb@salud.unm.edu, or Emma Naliboff Pettit, … >> Go To The Portal


Call to have a Complaint Form mailed to you either through the toll-free line (1-800-633-2322) or by calling (916) 263-2424, OR Use the On-line Complaint Form, OR Download and Print a Complaint Form

To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions), contact your State medical board.

Full Answer

What happens if you report a doctor for medical misconduct?

If you report the misconduct to the doctor’s office, group or hospital, you may receive an apology and an offer of help, which is great. However, for serious offenses, it’s also important that a regulating agency receive the information so they can take appropriate steps.

What should I do if I have been mistreated by a doctor?

Provide specific details and ask how they will resolve your issue. If you report the misconduct to the doctor’s office, group or hospital, you may receive an apology and an offer of help, which is great. However, for serious offenses, it’s also important that a regulating agency receive the information so they can take appropriate steps.

Can a physician refuse to authorize a patient to report?

Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision. Physicians should also protect patient privacy when reporting by disclosing only the minimum necessary information.

How do I report a physician who does not have hospital privileges?

This should include notifying the peer review body of the hospital, or the local or state medical society when the physician of concern does not have hospital privileges.

What is misconduct by a doctor?

Doctor misconduct is when doctors provide substandard care or behave unethically or unprofessionally. Misconduct ranges from improper diagnosis, medication errors and surgical mistakes to physical and/or sexual assault.

What is the most common complaint in clinical practice?

Common Patient ComplaintsScheduling difficulties. ... Disagreements with staff. ... Feeling unheard. ... Not getting enough time with the doctor. ... Waiting too long. ... Confusion with insurance and billing.

What is the most common patient complaint?

Studies have found that the vast majority of hospital patient complaints are related to the customer service they receive, specifically in the areas of:Staff/Patient Communication: 53 percent.Long Wait Times: 35 percent.Practice Staff Behavior: 12 percent.Billing Discrepencies: 2 percent.

How do you document inappropriate patient behavior?

In the patient's medical record, document exactly what you saw and heard. Start with the date and time the incident occurred, the location, and who was present. Describe the patient's violent behavior and record exactly what you and the patient said in quotes.

Which of the following is the most common cause of complaints within healthcare?

The most common issues complained about were 'treatment' (15.6%) and 'communication' (13.7%).

What best describes a verbal complaint of patient abuse or neglect?

A “patient grievance” is a formal or informal written or verbal complaint that is made to the facility by a patient or a patient's representative, regarding a patient's care (when such complaint is not resolved at the time of the complaint by the staff present), mistreatment, abuse (mental, physical, or sexual), ...

What are the 10 rights of the patient?

Let's take a look at your rights.The Right to Be Treated with Respect.The Right to Obtain Your Medical Records.The Right to Privacy of Your Medical Records.The Right to Make a Treatment Choice.The Right to Informed Consent.The Right to Refuse Treatment.The Right to Make Decisions About End-of-Life Care.

How do you address a patient complaint?

6 Steps for Dealing with Patient ComplaintsListen. As simple as it sounds, it is your first step in dealing with the complaint effectively. ... Repeat. Summarize what the customer said so they know you were listening.Apologize. I am often amazed by how powerful this one word is. ... Acknowledge. ... Explain. ... Thank the customer.

Do all doctors get complaints?

Nearly all GPs (97%) who responded to a survey from the Medical Defence Union (MDU) said they had received a complaint against them during the course of their career, with slightly lower figures for consultants (88%) and trainees (71%).

What is unprofessional behavior in healthcare?

Behaviors such as rude, loud, or offensive comments; sexual harassment or other inappropriate physical contact; and intimidation of staff, patients, and family members are commonly recognized as detrimental to patient care.

What to do if a patient is being inappropriate?

If a patient's behavior…is making you uncomfortable or causing you to feel unsafe, leave the situation immediately. Your personal safety and well-being are the most important. Federal laws on sexual harassment apply regardless of whether the harassment is taking place at a hospital or a doctor's office.”

How do you deal with rude medical staff?

Addressing Complaints of Rude Medical Practice StaffHere is a five-step approach to help you resolve this issue:Express gratitude for being notified. ... Take the blinders off. ... Find out more. ... Compile factual information. ... Invite your receptionist to meet with you.

What is the abuse in the exam room?

Patients in your exam room may be experiencing one of a number of forms of abuse—domestic violence, human trafficking or other violence— and identifying those being abused can sometimes be tough.

What to consider before reporting suspected violence?

What to consider before reporting. Before reporting suspected violence or abuse, the Code says physicians should: Inform patients about requirements to report. Obtain the patient’s informed consent when reporting is not required by law.

How many victims of trafficking had contact with a health professional?

The authors noted research showing that 88% of victims had contact with a health professional while being trafficked, but none were identified or offered help in getting out of their situation during the medical encounter.

Can a physician make exceptions to patient privacy?

Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision. Physicians should also protect patient privacy when reporting by disclosing only the minimum necessary information.

Do you have to see one on one for a trafficked patient?

Dr. Ravi said it is also important to establish a policy—even putting it in writing in the exam and waiting rooms—that says a patient needs to be seen one-on-one for part of the visit. Trafficked patients may come in with a man or woman who is trafficking them; sometimes that person could even be a relative.

There Was An Existence Of A Relationship Between The Patient And The Doctor

You must prove a physician-patient relationship between you and the doctor you are suing. Establishing a physician-patient relationship is straightforward once a doctor begins seeing and treating you. When a consulting physician does not treat you personally, it is common to have doubts about the existence of the relationship.

The Doctor Was Individually Careless

You must demonstrate that the doctor caused injury or damage to sue for malpractice. While the physician’s care does not have to be flawless, it should be professional and prudent. Almost every state requires the patient to present a medical expert who will outline the medical standard of care and demonstrate how the defendant violated it.

Certain Damages Were Caused By The Injury

Even though the doctor fell short of the acknowledged standards in their profession, the patient can’t simply sue for malpractice if the patient didn’t suffer injury. The following are some examples of types of harm for which patients may be able to make a claim:

In The Event Of Medical Malpractice, Additional Requirements

Medical malpractice lawsuits are governed by unique regulations and procedures in various states. It is vital to be aware of and rigorously adhere to these requirements.

As Soon As Possible After The Injury, Medical Malpractice Cases Should Be Reported

In most states, you have a limited period to file a medical malpractice claim. If you don’t file the case within the required time, the court will dismiss the case regardless of the facts.

Review Panels For Medical Malpractice

In many places, the patient must first submit a malpractice claim with a panel of reviewers. The experts will hear arguments, review evidence and expert testimony, and ultimately assess if malpractice occurred. The panel judgment does not replace an actual medical malpractice lawsuit.

Special Notice Requirements

Several states mandate that the patient notify the doctor about the malpractice claim in the form of a brief description before filing anything.

Why is it important to report doctor misconduct?

Certainly, the proper reporting of doctor misconduct is essential to help the appropriate agencies protect patients. If these agencies and organizations don’t hear of incidents, it’s impossible for them to investigate, take appropriate action and notify the public.

What is a doctor's misconduct?

Doctor misconduct is when doctors provide substandard care or behave unethically or unprofessionally. Misconduct ranges from improper diagnosis, medication errors and surgical mistakes to physical and/or sexual assault.

What is Medicare.gov?

Medicare.gov – to report improper care or unsafe conditions, and for complaints about a doctor or hospital. Joint Commission – to report safety concerns, such as medication errors and healthcare acquired infections.

What is the Patient's Right to Know Act?

Their “Patient’s Right to Know Act” requires doctors to tell patients if they have been “placed on probation for sexual misconduct, drug or alcohol abuse, inappropriate prescriptions or criminal convictions that involve harm to a patient”. Since this issue can impact all of us, let’s hope other states follow suit.

What is the state medical board?

State Medical Boards – to report concerns about a doctor’s unprofessional and/or incompetent behavior. Your state’s Attorney General office – to report issues including patient abuse and neglect. Medicare.gov – to report improper care or unsafe conditions, and for complaints about a doctor or hospital.

Can you find out about a doctor's disciplinary history?

Although knowing a doctor’s disciplinary history is important, only 27% of respondents to the FSMB survey reported they know how to find out about a doctor’s disciplinary history. Fortunately, you can find a lot of information online. But beware that not all misconduct is reported and recorded.

What is the number to call 911?

If you are having thoughts of harming yourself, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Online: Submit a new patient safety event or concern. Online: Submit an update to your incident (You must have your incident number)

Can the Joint Commission accept medical records?

By policy, The Joint Commission cannot accept copies of medical records, photos or billing invoices and other related personal information. These documents will be shredded upon receipt. Download the form for reporting a patient safety concern by mail.

About Patient Safety Confidentiality

OCR enforces the confidentiality provisions of the Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act) and the Patient Safety and Quality Improvement Rule (Patient Safety Rule).

What is PSWP?

Assembled or developed by a health care provider for reporting to a Patient Safety Organization (PSO) that is listed by the HHS Agency for Healthcare Research and Quality (AHRQ) and is documented as being within the provider’s patient safety evaluation system for reporting to a PSO

Complaint Requirements

Anyone can file a patient safety confidentiality complaint. If you believe that a person or organization shared PSWP, you may file a complaint with OCR. Your complaint must:

File a Patient Safety Confidentiality Complaint

File a Complaint Using the Patient Safety Confidentiality Complaint Form Package

How OCR Investigates Your Complaint

OCR will investigate complaints that allege potential violations of the Rule. To the extent practicable, OCR will provide technical assistance and seek informal resolution of complaints involving the inappropriate sharing of PSWP through voluntary compliance from the responsible person, entity, or organization.

How to complain about poor care in a hospital?

How can I complain about poor medical care I received in a hospital? While you are in the hospital: If possible, first bring your complaints to your doctor and nurses. Be as specific as you can and ask how your complaint can be resolved. You can also ask to speak to a hospital social worker who can help solve problems and identify resources.

What do you do if you get an infection in the hospital?

If you get an infection while you are in the hospital or have problems getting the right medication, you can file a complaint with the Joint Commission . This group certifies many U.S. hospitals' safety and security practices and looks into complaints about patients' rights. It does not oversee medical care or how the hospital may bill you.

What do social workers do when patients leave the hospital?

Social workers also organize services and paperwork when patients leave the hospital. If you are covered by Medicare, you can file a complaint about your care with your State's Quality Improvement Organization (QIO) . These groups act on behalf of Medicare to address complaints about care provided to people covered by Medicare.

How long does it take to appeal a hospital discharge?

You should get a form from the hospital titled "An Important Message from Medicare," which explains how to appeal a hospital discharge decision. Appeals are free and generally resolved in 2 to 3 days. The hospital cannot discharge you until the appeal is completed.

Can a hospital discharge you until appeal is completed?

The hospital cannot discharge you until the appeal is completed. When you get your hospital bill: First, ask your doctor or the hospital's billing department to explain the charges. Find out how the hospital handles complaints about bills, and make your case. If you still have questions, you should contact the Medicare carrier ...

What do we need to follow up on a complaint?

In order to follow up on your complaint, we may need to share the information you give us with the business you complained about or with other government agencies. This may include sharing personal information you gave us.

How to file a complaint against a company?

There are three ways that you can file a complaint: 1 Call to have a Complaint Form mailed to you either through the toll-free line (1-800-633-2322) or by calling (916) 263-2424, OR 2 Use the On-line Complaint Form, OR 3 Download and Print a Complaint Form

What is the disclosure of information you provide?

The information you provide may also be disclosed in the following circumstances: In response to a public Records Act request, as allowed by the Information Practices Act; To another government agency a required by state and federal law; In response to a court or administrative order, a subpoena, or a search warrant.

Why report a colleague who is incompetent?

Reporting a colleague who is incompetent or who engages in unethical behavior is intended not only to protect patients , but also to help ensure that colleagues receive appropriate assistance from a physician health program or other service to be able to practice safely and ethically.

Why is medicine a self-regulated profession?

Medicine has a long tradition of self-regulation, based on physicians’ enduring commitment to safeguard the welfare of patients and the trust of the public. The obligation to report incompetent or unethical conduct that may put patients at risk is recognized in both the ethical standards of the profession and in law and physicians should be able ...