“My receptionist of 17 years quit last August, at 39 years old. She and her husband had decided it was time to have a child,” says a 53-year-old family physician in New Westminster, BC. “A happy event, of course, but I was devastated. She ran the practice like a well-oiled machine. Handling appointments, scheduling lab tests, paying all the bills, bookkeeping — the only thing she couldn’t do was practice medicine. That she left to me. A perfect arrangement.”

Losing his key employee was the start of what turned out to be a more serious problem.
“I used an employment agency to find a replacement and took temporary help to carry me over. It took about six weeks to find someone. When the new person started, I thought my troubles were over,” the doctor explains.

“Everything went smoothly at first; then I noticed that the waiting room always seemed to have a crowd in it. Some days there was standing room only. When I asked about it my new staff person complimented me for being in such high demand. One of my oldest patients, Mr. King, wasn’t nearly so diplomatic.

“On a visit for a checkup he blasted me for keeping him waiting. He’d been coming to me since my first year in practice and I considered him a real gentleman.

“He told me that the last time he came for a checkup he’d waited for and hour and 15 minutes and finally left. He even had trouble booking a new time. He said if he thought I practiced medicine the way I ran the practice he’d find another doctor.”

What began with complaints over trouble getting appointments ended with two other patients questioning the doctor’s clinical competence. One woman, whom he’d always considered meek and mild, demanded he prescribe a product she’d seen on TV. She was rude, almost threatening when he refused on the grounds that it wasn’t intended for her condition.

The New West physician knew his new staffer had to go. Setting things right was more of a challenge. She’d been at the practice for just over three months, her probationary period was over and when he asked her to leave she demanded six month’s severance pay and threatened to take him to the Labour Relations Board. His lawyer suggested it might be cheaper just to pay up and, in the end, that’s what he did.

He probably got off easy. Complaints that begin in the waiting room can escalate into serious patient-doctor confrontations that may even end up in court, caution practice consultants and lawyers who’ve handled malpractice cases.

They suggest every practice should have a policy for handling complaints. The first rule is to discuss any complaints calmly and professionally. If you find the conversation is getting out of hand, see if it can be rescheduled until tempers have calmed.

Problems to do with scheduling are ideally handled by your staff, but make sure to review complaints routinely and suggest solutions. More serious issues — for example patients who feel rushed and question the quality of care — should be handled by you directly with the patient. Don’t discuss cases with other members of the family without the patient’s consent and keep good notes on interactions. In cases where there’s even the hint of a malpractice suit, contact The Canadian Medical Protective Association (CMPA) and be guided by their advice.

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