The customer is always right

As a podiatrist, you will come into contact with a range of patients in the course of your working day. Dealing with difficult patients requires patience and skill. The adage, ‘the customer is always right’ is a worthy one to adopt, but strategies are required to negotiate through an encounter with a difficult patient. Effective communication, good record keeping and where appropriate, referral, are some of the skills which can be used.

Guild Insurance is seeing a number of claims where patients are intent on taking a complaint to the Board or other official body. Patients often have limited understanding of their own condition or the treatment options available to them, or in some cases the costs involved in the treatment they require. 

Accordingly, patients must be provided with:

1. a clear explanation of proposed treatment options;
2. an explanation of any inherent risks and benefits of the proposed treatment options;
3. details of the costs of proposed treatment options;
4. a range of alternatives to the proposed treatment options;
5. adequate time for any questions from the patient in relation to proposed treatment options to be answered by the practitioner.

Finally, you should confirm with a patient that they have an understanding of points 1 – 4 above and that all questions posed by the patient have been answered. Provision of clear and accurate information enables the patient to make an informed decision whether to proceed with treatment.

Patients place their trust in you when they attend at your practice for treatment; often your rapport with the patient has been built up over a period of time. By virtue of your qualifications and experience as a health practitioner, there is an obligation to provide a high standard of care both in relation to your treatment and your dealings with your patients.

Patients are far less likely to be dissatisfied, and therefore motivated to make a claim, if they have received prior warning of the risks, and consent to the treatment on the basis of being well informed on their specific circumstance, and the most likely outcomes. It is important to remember that how much you inform the client is not based on what you consider relevant to the client but what the client considers relevant.

Records need to capture critical information, not simply the date the patient has attended or paid but the interaction with the patient. This includes, tests, their results, any warning provided to the patient, recommendations provided, care options explained, the client’s consent to the treatment and the clinical notes supporting the care provided.  The record needs to tell a story, that will in 5 or even 10 years after the event provide a reasonably clear description of what has taken place, and the basis of the decisions made at the time.

Whilst podiatrists are often highly competent and skilled in a wide range of areas there are times when referral or discussion with the patient regarding referral may be appropriate and should be considered. A referral, after all, is about looking after the best interests of the patient.

To discourage a patient from pursuing a complaint to the Board, it is important that a patient’s expectations are managed through clear communication and documentation that supports the discussion and the decisions made. Consider this in an adversarial context, where you need to defend your actions against an allegation.
 
If a client raises a complaint do not ignore or rebuff their concerns. You are more likely to achieve a positive outcome if you take the time to listen and respond to their grievances. Showing empathy, listening to what your client has to say and advising (where necessary) that you will look into the matter is not admitting liability for an incident.

If an incident does occur, contact Guild Insurance on 1800 810 213. Your Guild Insurance policy provides up to $100,000 legal fees cover for representation before a Board or inquiry, and our experienced legal team can provide immediate assistance when a complaint is brought against you.

Managing patient expectations through clear communication and records

Despite a podiatrist’s best efforts, a claim or complaint can occur when treatment doesn’t meet a patient’s expectations.

Guild Insurance has found that claims or complaints often involve the issue of orthotics and that communication is critical when dealing with orthotics effectively. The Clinical Guidelines for Orthotic Therapy Provided by Podiatrists published by the Australian Podiatry Council, details the information that should be provided to patients where orthoses are the recommended treatment modality.

Read more: Managing patient expectations through clear communication and records

Employer? Employee?

Do I need my own cover?

Is professional indemnity (PI) insurance cover best held by the employer or the individual practitioner?

Guild Insurance provides cover on an individual practitioner basis as we view this as the best way for podiatrists to meet their PI insurance requirements.

Read more: Employer? Employee?

What support do you have in defending your reputation?

Receiving a complaint from a patient or an inquiry from the registration board can be a stressful experience. When your professional ability is brought into question and your reputation is at stake, you need the best support and advice available.

Read more: What support do you have in defending your reputation?