Two Sides to Every Story: Complainants' and Doctors' Perspectives in Disputes about Medical Care in a General Practice Setting

Abstract

The paper examines 110 complaints about general practitioners adjudicated by a health authority. This was a 10 percent subset of complaints received. Complainants' letters were analyzed in order to identify the issues complained about, who complained, what they wanted and how they structured their accounts. The most common single cause of complaint was the lack of a home visit but a third involved issues of diagnosis and treatment. Most people complained to get an investigation rather than for personal redress. Very few considered suing. Doctors, in their response to complaints adopted a number of defence strategies. In a minority of cases they stepped outside the bounds of professional behavior. In the light of impending changes in complaints systems in the U.K., it is argued that a forum for the expression of conflicting accounts remains.

Exploring the Meaning of ‘Dissatisfaction’ with Health Care: The Importance of ‘Personal Identity Threat’

“…Nettleton and Harding (1995), in their study of 107 letters of complaint to an FHSA (Family Health Service Association), comment that complaintmaking on behalf of close kin was seen as part of their 'caring role' by the women. Allsop (1994) also found that women were more likely to complain on their own behalf. This may be because women make greater use, and have more experience of health services, and as a result have higher expectations of practitioners (Allsop 1994, Mulcahy and Lloyd-Bostock 1994, Mulcahy et al 1996).…”

“…However, with the exception of Tritter (1994, 1998), and Annandale and Hunt (1998), dissatisfaction is mainly examined either through research aimed at measuring satisfaction, or studies which explore complaint-making in the National Heath Service (NHS) (Owen 1991, Allsop 1994, Nettleton and Harding 1995. I argue that patient satisfaction surveys are inadequate for exploring dissatisfaction with health care.…”

Withering the Citizen, Managing the Consumer: Complaints in Healthcare Settings

“…Research and commentary on the social and psycho-dynamics of complaints indicate that making a complaint often involves families and kin networks, particularly in more complex and serious cases (Allsop, 1994;Lloyd-Bostock, 1999). Holding people to account, disclosure, being given an explanation and having an opportunity for forgiveness through personal interaction with those responsible can be critical elements in resolution but do not currently feature in the Health Commission's repertoire (Robinson, 2005).…”

“…Felstiner, Abel and Sarat (1981) have shown how a range of factors determine the likelihood of people voicing a dissatisfaction that vary according to the particular sector. A feature of healthcare complaints is that they may be influenced by an emotional burden of harm and loss that affects families as well as individuals (Allsop, 1994;Lloyd-Bostock, 1999).…”

Pathways, Pyramids and Icebergs? Mapping the Links Between Dissatisfaction and Complaints

“…Table 7 confirms the importance of health care professionals in the handling of dissatisfaction. Together with Table 6 it makes clear the limited importance that respondents placed on financial and publicity outcomes in Total N = 298 1 approaching professionals to complain (see also Lloyd-Bostock and , Allsop 1994. Out of 373 approaches to members of formal networks it was in only six cases, less than two per cent, that there was a financial motive for their actions.…”