May 2010 Volume 34 No. 5
Help patients while preventing regulatory hassles: respond promptly to physician complaints

Physicians have been reminded that the “clock starts ticking” whenever a care-related complaint involving a physician is received at SHC.

When a complaint comes in, call (650) 498-3333 and ask for a senior patient representative. “Complaints must be responded to by the hospital very promptly — mainly because we hope to be able to assist the patient and family involved and thereby recover from any service lapse which may have prompted the complaint,” said Cynthia Mahood-Levin, director of executive programs and service quality at SHC Guest Services. “But in addition, CMS and other regulatory agencies require a response within 7 days.

Guest Services has responded to Medical Staff input and now ensures that physicians are notified promptly whenever they receive a patient or family complaint about the physician’s care. Patient representation staff members are then available to provide guidance and to serve as the point of guidance and contact with the patient, said Mahood-Levin.

But not all complaints are initially directed to Guest Services, so it’s equally important that physicians, clinic staff and others realize that all written complaints (including emails) and significant verbal complaints or grievances involving patient care must be promptly forwarded to SHC’s Patient Representation at Guest Services. This is necessary so that representative staff will have a reasonable opportunity to resolve the complaint within seven days, Mahood-Levin explained. Service complaints, such as housekeeping or appointment wait times when patient care isn’t compromised can be handled by managers or supervisors and need not be forwarded to patient representation, Mahood Levin said, “but the distinctions can be subtle, so if in doubt, please call.

“Don’t try to respond yourself or assume someone else is taking care of the complaint. If not responded to within seven days, these complaints can and have been forwarded by patients to the Joint Commission, California Medical Association, the Better Business Bureau, the California Department of Public Health, and/or the Centers for Medicare and Medicaid Services (CMS),” she said.

“Please take any complaints seriously and rest assured that Guest Services personnel will provide supportive follow-up, keeping the physician fully informed throughout the process,” said Bryan D. Bohman, chief of staff. “We are mounting a large Medical Center-wide effort to improve service globally and thereby reduce the number of complaints, but excellent service always includes a prompt and appropriate response whenever a complaint is generated.”

Bottom line: as soon as a complaint is received, the seven-day window is activated. Call (650) 498-3333 and ask for a senior patient representative, available between 7 a.m. and 7 p.m. “A representative will answer any questions and support you through the process,” Mahood-Levin said.