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Practice dilemma: A complaint from a spouse

The wife of a deceased patient has repeatedly made complaints to the practice regarding his care. The practice has tried very hard to answer all her concerns but she remains unsatisfied. You feel that the relationship with the patient has broken down. Can you remove her from the practice list?

First of all, it is important to remain objective in this situation. Attempts to address the concerns may have proven futile but she remains on the practice's list and so demonstrates a desire to continue with the doctor-patient relationship.  Her concerns may reflect a genuine anxiety about what happened to her husband or may demonstrate the anger she feels at the loss. 

Either way she has a right to seek answers and to voice her concern while still receiving the practice's care. To remove her from the list is likely to be seen as punitive and unfair.  The GMC's ‘Good Medical Practice' paragraph 38 states that you should not end the doctor-patient relationship because of a complaint.  This is a view supported by the Health Service Ombudsman.

It is important that all avenues of local resolution are exhausted, and a meeting with the complainant may help with this.  Asking the patient whether she wants to stay at the practice may be the acid test of how she feels about the GPs.  As professionals you and the team will be expected to treat her fairly and not allow personal emotions to cloud your judgement.  Talking it through with an impartial party such as your MDO can be invaluable.

Dr Pallavi Bradshaw is a medicolegal advisor at the Medical Protection Society