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Practice dilemma: Partner's bad manners

A patient has complained to your practice that the conduct of one of your GPs in a recent consultation was rude and unprofessional. How should the practice proceed?

A patient has complained to your practice that the conduct of one of your GPs in a recent consultation was rude and unprofessional. The practice manager has given the GP a copy of the complaint, but his account of what happened is at odds with the patient's account of the consultation. How should the practice proceed?

Concerns about manner and attitude are frequent in primary care. The practice must follow their complaints procedure, acknowledge the letter within three days and agree a plan of action. Offering an initial meeting can avoid escalation.

Personal criticism can be frustrating, but it is important to avoid an overly defensive response. Instead, the GP should reflect on why the patient felt that way during the consultation. There may have been an identifiable breakdown of communication which could be addressed for future practice. A simple misunderstanding or cultural difference may account for the discrepancy in the events described. The GP should accept that for whatever reason the patient is upset, regardless of whether the feelings are justified.

The GP should provide the person who is coordinating the complaint with an account of the consultation based upon the notes and their recollection, making their own position clear, but without needlessly emphasising the areas of conflict. Acknowledging that the patient's feelings of upset or anger are real regardless of cause, along with an apology for the unintended distress can lead to a successful resolution. When this cannot be achieved, the patient may be advised that they could consult other GPs in the future at the practice. The patient must be made aware that they can ask the ombudsman to review the complaint if they remain dissatisfied.

Dr Pallavi Bradshaw is a medicolegal adviser at the Medical Protection Society in London

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