Every practice has them: disgruntled employees and patients. They come with the territory and there's nothing you can do to eliminate the problem. But you can handle it better, and with less expense.
Most of the time, it's easy enough to spot the problem with patients: they complain to your face or (perhaps more frequently) to your staff. With you the practitioner, the problem is probably clear. The patient did not get the result he wanted. You have a sense of this through your consultations with the patient.
It can be trickier where the complaint is to staff, not just because staff may not want to bother you with the issue. This is because the patient strikes out at someone with perceived lower status, and the issue appears to be personality-related rather than a problem with your office. Maybe you kept the patient waiting, appeared too focused on your computer than upon the patient when you met. Maybe your tone was taken as brusque. None of this will be brought to your attention, but the outlet for frustration may well be your staff — and for nothing in particular that the staff itself may have done.
It is harder still with employees. Sure, you may figure that an employee you regularly chastise for being late may resent your policies. Far more often though, you have no idea just what it is that may have built up the resentment and feelings of being wronged. Employees speak with each other, not with you. And the first you may even hear of it may be after the employee has been fired or quit.
The world of complaints is divided into three parts: the informal complaint, the administrative charge, and the lawsuit.
The patient is most likely to write an email complaining about your practice and use that as an excuse to avoid paying a bill. There may be a threat of reporting you to an administrative body. Perhaps there will also be a threat of a negative Yelp review. This is an “informal complaint” because the dispute is at this point just between you and the patient. There's a good chance that simply writing off the bill will resolve the issue (which is not to say you should do that – see below).
The administrative charge is what comes next if the patient remains dissatisfied. This is the complaint to the licensing board or the Better Business Bureau. Regardless of the merits, you are going to have to defend yourself, and that will require re-reviewing the chart and collecting data from your administrator. You can win, but it's still a hassle.
From the employee side, the administrative charge is likely where you'll first hear of their complaint. Most often a former employee will ask an administrative agency to make you pay seemingly picayune amounts of additional pay for vacation, meal times, mileage, overtime, etc. — but the relevant Labor Code may impose hefty penalties on top. It's virtually impossible to conduct your business in a way to avoid ever having this situation. The law is simply too complex. But it is equally virtually impossible to get out of the situation without having to pay something. The administrative agency is ordinarily pro-employee and seeking an easy resolution by which you pay a good part of what the employee wants. When the alternative is paying an attorney a considerable amount of money, this is often the appropriate decision (not always though).
The main reason it may not be wise is that the administrative charge may not be all that the employee wants to complain about. There's no point in settling one charge only to face a lawsuit (see below).
The lawsuit almost always begins with what we in the business call a "demand letter" — an attorney writes to you offering to settle a client's complaint against you for an exorbitant amount of money, or else. Mostly (but not always), if a lawyer is writing this letter, the lawyer believes that the case has some merit and is willing to invest time for free, knowing that eventually you'll have to pay money to both client and lawyer. When a lawyer's involved, you now have two adversaries: your patient/employee and the lawyer. You can win, but it will be expensive.
Before you get to this point, it's important to realize you can avoid this.
What to do
Your best bet here is an early apology to either the patient or employee, along with some financial nod to show you mean it. There are ways of doing this without admitting liability or wrongdoing, but they are far less likely to pursue a matter against you if they felt that you handled the issue with respect and not defensiveness. Of course you may well be right. But that's not the point: the point is to take steps to minimize this sort of conflict in your practice and your life. If you wait until the administrative agency (and heaven forbid, a lawyer) is involved, the patient and employee now have advocates in their court and are more convinced than ever that they are right and you are wrong.
Encourage an office culture of open communication and willingness to resolve disputes, whether with patients or with employees. And one constructive suggestion: when faced with a complaint, set aside time where you simply hear a complaint out and save your response for a later time. Yes, it's a bit inefficient, but if you have a ready answer to a complaint, you will come across as defensive and dismissive, and that's a great way to encourage the complaining party to double-down and keep the dispute alive.
The information contained here is observational, and should not be considered legal advice. Legal advice is situation-specific. If you are interested in seeking legal advice, please contact Hershenson Rosenberg-Wohl, A Professional Corporation, at (415) 829-4330. David Rosenberg-Wolh can be reached at [email protected].