Making a complaint about a medical provider
April 7, 2018 4:35 AM   Subscribe

A few weeks ago I got sick. I saw a family nurse practitioner (FNP) at a local clinic every day for five days as my symptoms worsened. They failed to listen to my concerns or accurately diagnose my condition and I ended up in the hospital for treatment of an acute infection. I'd like to make a complaint, but how best to do that?

I had a range of symptoms when I first went to the clinic, but there was one set of symptoms that was especially worrying to me. At every visit with the nurse practitioner I raised my concerns but they dismissed those symptoms as not being significant. Unfortunately, I listened to them and decided to stay under their care, instead of seeking another provider. They diagnosed and prescribed treatments for other conditions that turned out to be incorrect. Finally, after a week, the symptoms I'd been worrying about became significantly worse and the provider had to acknowledge that there was an acute infection where I had indicated. However, they again misdiagnosed it and prescribed at-home treatment. Shortly afterwards my condition deteriorated and I took myself to the ER, was diagnosed with a serious infection, and was admitted to the hospital for four days of IV antibiotic treatment and tests, followed by 10 days of at-home antibiotics.

I believe that the provider seriously erred in their assessment of my condition and they clearly ignored symptoms that I reported. I would like to make a complaint in a way that will result in the clinic seriously reviewing the actions of this provider and perhaps review the way that their nurse practitioners diagnose edge-case conditions (as opposed to the high volume of very common ailments they see). I have since heard from several other providers, who I trust, that my condition was rare and had an unusual presentation. But I don't think that it was inevitable that I would end up in the hospital. The clinic has many doctors and other professionals on staff that the nurse could have consulted as my symptoms continued to worsen, despite treatment.

Potentially complicating things, the nurse works for the premier medical clinic in my small community. My family and I have been seeing providers at this clinic for years and, until now, have been very happy with our care. We would like to continue to see providers there, though never again this particular nurse. But I'm concerned about burning bridges. I'm worried, in a sense, about myself and my family becoming "problem" patients at this clinic. Of being treated reluctantly, or of being treated as potential risks to be avoided, instead of patients with legitimate health issues.

At this time I am not interested in taking any legal action. Thankfully the infection appears to be gone. I'm fortunate to have insurance that should cover the majority of my costs and I was able to take leave from work (though I burned essentially all of my banked leave). I have considered writing a letter detailing my concerns to the board that controls the clinic. The board is composed of all of the MDs who practice at the clinic, who are also the corporation's shareholders. I have also considered writing a letter to my state's medical licensing board. Aside from legal action, these are the two places I can think of to lodge a complaint.

After all this, I think my questions boil down to: does anyone have any advice or experience making such a complaint? Are there other ramifications that I should consider? Even though I don't intend to take legal action, should I consult with an attorney before sending a letter to either the clinic or the licensing board? Are there other potential avenues for directing such a complaint? Am I right to be concerned about how this will affect our reputation at this clinic, or should that be a minimal consideration in this kind of situation? Thanks in advance for any advice.
posted by anonymous to Health & Fitness (7 answers total) 1 user marked this as a favorite
Most clinics have a published policy on how to file grievances. Do you have a copy or can you find it on their site?

It is very likely that any hint of legal action will result in the clinic discharging you as a client. This happened to me as a teen when my non-custodial father, who is a lawyer, wrote a nasty-gram to my psychiatrist, resulting in him refusing care not only to me but the rest of my siblings. This is not to say that you shouldn't complain, but follow the clinic's procedures for grievance instead of a legal route if you want to remain patients of other partners there.
posted by peanut_mcgillicuty at 5:56 AM on April 7, 2018 [2 favorites]

Call the clinic and ask to speak to the practice manager. Ask how to file a formal complaint. Your complaint should be in date order, factual and detailed. Detail the emotional and stress consequences, loss of work, added expense. This health care provider ignored your concerns, did not refer you to a more qualified practioner, and you became dangerously ill a a result. Your state has a medical board, listed on the Attorney General's website. Somebody regulates nurse practitioners. You may want to send them a copy of the complaint.

You should decide what result you want. An apology, an assurance that the employee will be trained/ disciplined, reversal of charges, something else. Your complaint will help the next patient. I'm so sorry you had to experience this and I hope your okay.
posted by theora55 at 6:08 AM on April 7, 2018 [3 favorites]

I would start internally; as above, with the practice manager. One of the words you probably want to use is 'collaborate' - because in many states that's how the agreement is worded. I'd say something about how you were concerned that there was a failure or lapse in collaboration between the fnp and md/do as your symptoms escalated or did not improve.

State by state regulations differ for NPs - I'm in a state that requires collaborative agreements that basically mean I have to have an MD/DO available to collaborate with when things are tricky or unusual. There is no specific cutoff, however, that says when that occurs, so it's based on clinical judgment. I've had MDs who were very hands off (and hard to reach) and ones who wanted calls or texts for almost anything prescribed. This may be a practice culture or an instance of individual poor judgment, but internally is the best way to start.
posted by cobaltnine at 6:37 AM on April 7, 2018

I've made several grievances against medical providers for similar failings. As others have said, just call up the clinic and ask to file a "Formal Grievance" (which, depending on the office can differ from just a regular ol' grievance/complaint....). Most states require a formal grievance process to be followed. Clinic management, board of directors, licensing board in that order.

If they balk at any step along the way, or you even get the hint that they are unwilling to take this seriously at any step, just bypass whatever level you're on and go straight to the licensing board, and let them know it. Sometimes, letting them know that you're aware you can complain to their licensing board is enough to get them to basically go "woah woah woah, we'll totally deal with this, don't worry please oh please don't do that." Getting a complaint through the licensing board is usually a hectic process for the clinic and the individual the complaint is filed about. This will put the clinic on fucking ALERT that this is a Real Problem™ and the providers that fucked up will be much more cautious going forward.

Bud do think about what you want out of this process. Neither one of these outcomes will fix things for you, and yes, will likely damage your relationship with at least that provider. If the clinic is professional, you likely won't have any problems with other staff; if the clinic isn't, they were not the premiere, amazing place you thought they once were.
posted by furnace.heart at 8:30 AM on April 7, 2018 [2 favorites]

I don't know that I'd make any sort of complaint -- being wrong is not the same as being negligent or committing malpractice, and you had a rare condition with an unusual presentation, which is the sort of thing that unfortunately is likely going to get misdiagnosed multiple times before people can figure out what's going on -- but if I were going to, I would focus almost exclusively on feeling dismissed or not listened to by the FNP. That's potentially fixable; the general process of diagnostic rule-out is not particularly fixable.
posted by lazuli at 10:11 AM on April 7, 2018 [8 favorites]

If you decide to go the formal complaint route: before you make any sort of complaint, the first thing you should do is get a copy of your records. This is so that they cannot be altered after your complaint is filed. Present yourself as "oh, we always get a copy of our records just in case we move or something". You may have to pay a copying fee. Also, your records will likely not be available for 30 days. Write your complaint/timeline now while the details are fresh in your mind, but don't file it until after you have your records.
posted by vignettist at 12:32 PM on April 7, 2018

We went through a similar experience with Kaiser (my husband’s appendix burst over 3 days of Urgent Care visits without being diagnosed; he was out of work for 4 weeks and lost 15% of his body weight). We complained and filed a grievance. Nothing happened. Like, at all. After stewing and mulling it over and speaking with doctor friends for months about our frustration... we decided not to be angry anymore. We decided that the mistake could have happened anywhere, no matter what doctor we saw, and we still go to Kaiser for medical care.

I’m not trying to discourage you. You should file a grievance. However, I encourage you to make your peace with what happened, if only so you don’t make yourself crazy with anger, as we did for a while.

I’m sorry this happened to you and glad you’re OK now.
posted by samthemander at 11:26 PM on April 7, 2018 [3 favorites]

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