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Complaints: traditional and modern considerations
  1. Philip D Welsby
  1. Retired, Edinburgh, UK
  1. Correspondence to Dr Philip D Welsby, -, Edinburgh EH12 8UB, UK; philipwelsby{at}

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What follows is obviously based on UK practices but, no doubt, similar circumstances apply elsewhere.

Informal complaints, ‘dissatisfactions’, can often be resolved by prompt face-to-face explanations with detailed listening and acknowledgement of a complainant’s distress. Dissatisfactions and complaints (derived from Old French ‘to lament’) are to be expected because most things in medicine are not 100% defined, and this often includes causes of illness, the most appropriate treatment for an individual with that illness, the benefits of treatment that were anticipated, the incidence and severity of side effects of treatments, and the inevitability of false-positive or false-negative results. If initial explanations do not resolve matters or if patients obviously intend to take matters further then more formal responses are required.

There are statutory duties of candour in England and Wales1 and in Scotland2 requiring health services and practitioners to give factual explanations and to apologise after notifiable incidents. Because medical care is becoming increasingly complex and involves teamwork, it is to be expected that ‘system failures’, often a concatenation of individually insignificant minor errors, will increase, and often clinicians, even if totally blameless, may find themselves in ‘the front line’ and often have to respond to complaints.

Some traditional considerations

In the UK, there are eight official ‘traditional’ bodies that might become involved when a complaint is made.

Medical defence organisations are there to protect the interests of doctors. They are not-for-profit mutual organisations paid for by subscribing doctors and provide, among many other things, expert medicolegal advice and support and robust defences, along with financial cover when clinical …

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  • Contributors The author is the sole contributor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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