Positive experience

05 March 2013
Volume 29 · Issue 3

Alexander Holden explains how he dealt with a recent patient complaint.

I have written before about patients who complain and how they tend to be demonised rather than learnt from. Writing these articles could be described as cushy; I sit in my ivory tower, writing about issues I think are interesting, I can pontificate in comfort about my opinion and how I would deal with a situation. Well I thought I would share my experience where my ivory tower crumbled leaving me very clearly in the firing line.

I sat there in the surgery, my stomach fluttering in a way it hasn’t done since my school days when I would be told off for some misdemeanour or indiscretion. As the door opened and the patient strode in, I felt what can only be described as panic, as if the sword of Damocles poised above my head had finally dropped; this was the patient who was about to complain.

Before I carry on with the story I began with, I thought I might share a bit of background as to my view with dealing with those who have a grievance with me. As a boy at school going through the awkward phase of being angry with the world, if I was pushed I would push back just as hard. It wasn’t till the age of 15, whilst on a family holiday to Scotland that I learnt a different way. My father, a quiet man, had taken us on a hike that followed the old railway line between Peebles and Edinburgh. We had lost the line temporarily and the ordinance survey promised that we would find it once again after traversing one of the area’s many fields. Halfway through the pasture an old man appeared shaking his fist and cursing, he was shouting irately for us to get off his land.

The farmer came striding up to my father and told him if we didn’t leave immediately, he would set his dogs on us and leave them to it. I remember watching wide-eyed wondering how my father was going to react. My father smiled and simply said, “Oh alright, sorry. We are just trying to get onto the old railway line to follow it back into town, can you show us?”

Most men would have been so upset at them and their family being threatened with mauling that they would have probably have resorted to the same coarse language and bravado. The farmer was not expecting politeness. I was almost certain he would resent showing us how to get back on track whilst avoiding his land, but show us he did. To top it all off, once he had put us back on course my father said a line I will never forget, “Thank you for your courtesy”. The farmer didn’t know what to say, he was fully aware he had been as far from courteous as one could be, but he wasn’t going to correct my father on that point.

Back to the present day - sitting in the surgery I knew that the next patient would be on the warpath. He was an elderly gentleman who had attended for the impression for an addition to his denture the week previously. I had been running late, so after taking the impression and explaining the next step, I turned my back and began writing my notes. My nurse is fantastically capable but on that occasion she had been less than perfect with her alginate removal from the patient’s face. Luckily the receptionist had spotted this and had helped the patient remove the remainder from around his mouth.

The morning of the ‘fit’ appointment, the receptionist warned me he had told her that he would be giving me a piece of his mind. Sure enough, the second he stepped in to the surgery I was made to feel like a boy caught with his hand in the cookie jar. “Quite frankly I have an issue with your standard of care” he shouted at me. “I can’t believe you let me leave the surgery like that, I was going shopping with my wife after that, can you imagine the looks at the supermarket?”

Almost immediately the 15 year-old in me wanted to tell him to stop making something out of nothing, to get some perspective and leave me alone. Of course, such a response would have been like pouring kerosene on a fire. Then I imagined myself back in the field and remembered my father’s skill at deflecting aggression. I began by apologising for the way he felt, then I asked him if he was happy to still be a patient and place his trust in me. He said he was. At this point the patient had started to warm up; he was no longer aggressive and was back to being as pleasant as one would want. The grand finale came after I had fitted the denture. As he was leaving my room I stopped him. I apologised once again and thanked him for giving me feedback on how I had done, and said I hoped he would continue to let me know what he thought of my care.

I actually feel the patient had a valid complaint; he felt we hadn’t looked after him as much as he would have liked. When complaining the patient was only doing what I would want every patient to do; to be honest about how happy they are.

I suppose our natural reaction to complaints is to give as good as we get, but this is dangerous because it takes away from being professional and isn’t in anyway conducive to finding a solution. Thanking people for their input and reacting positively to complaints is far more helpful than getting upset by them. Hubris isn’t the most attractive quality in a dental professional and I think when it comes to complaints, it is far better to act proactively and grow trust and co-operation with patients than break it just for pride’s sake.