How To Raise Complaints Against Health Care Providers

Do you have a grievance about your health care provider? If you’d like to complain about unprofessional conduct or service and get results, here is a simple plan of action.
Financial
By Rebecca Higgens
A doctor at a laptop with a paper bag over his had with an angry face drawn on to it

If your health care provider behaves in a way that feels unprofessional, take note. It may be time to raise a complaint, speak up, report inappropriate behavior or move to another provider.

As a consumer and patient, you deserve professional conduct and adequate care from your doctor. You deserve to be treated with care, humanity, and respect.

If you have a grievance, you are not just being picky—you are in a good position to be proactive.

If You Have Concerns

Many people don’t know where to turn when they have concerns about conduct or competency of their healthcare provider. This is why it helps to know that you can go to a state medical board. The Federation of State Medical Boards (FSMB) provides contact information for every state medical board in the United States and it’s territories.

These are government agencies with the mandate to investigate complaints about doctors, and when warranted, to take action against them.

Here is a quick overview of how to raise complaints against your health care provider—and get results.

Keep Records

As you know, keeping precise records positions your experience in an objective framework. What exactly occurred? What was said, done, or inferred? Who else was involved? Are there any witnesses? Who did you tell?

By keeping track of one or more experiences, you can gather facts. Your detailed data my provide evidence reflecting a behavior. It may also show a pattern of behavior.

Get Another Opinion

Think about whom else you could talk to give perspective, and provide an expert opinion. Consider talking with another doctor or medical practitioner in the same practice.

If you are in a network, many hospitals and private practices have a process for handling complaints. This process maybe in place. With a little investigation, you can talk with an administrator to handle and address your grievances.

Doctor speaks with a frustrated male patient

Explore History

Doctors and medical professionals do not exist in a vacuum. There are detailed records available to the public, regarding their behavior, performance, and treatment histories. To investigate, you may want to check with Doc Info to verify a doctor’s license and professional background information.

Contact Your State’s Medical Society

If these actions have not produced a satisfactory outcome, you may need to escalate your actions. Contact your state’s licensing board or medical society. Find out how to file a complaint. Most states list the exact instructions on their websites.

To locate the one in your area, go to the American Medical Association’s website: ama-assn.org and look in the Professional Resources section. You’ll find more instructions under “medical ethics.”

Investigate Consumer Complaint Hotlines

States vary in how they process complaints. Some states such as Texas and California offer a consumer hotline. You can call these to explore your options and get advice on how to proceed.

Depending on your state, you maybe able to file a formal complaint, online or by mail. Once your complaint is filed, the medical board will review it.

If the board finds a violation, it could take action. This may range from a fine to a revocation of the physician’s license.

A senior female sits with female doctor frustrated with her advice to take pills

Common Complaints

If you’re thinking about making a formal complaint, it may help to know some of the most common standard-of-care complaints.

These include:

  • Incorrect prescriptions
  • Inappropriately prescribing controlled substances
  • Failure to diagnose a medical problem
  • Violating patient-doctor confidentiality
  • Disruptive behavior that interferes with patient care
  • Failure to provide appropriate care after operations
  • Failure to respond to a hospital call to help a patient in a traumatic incident

Complaints are prioritized according to the potential for patient harm. For example, if an investigator determines imminent patient harm, this report is “fast-tracked.”

Some of the types of complaints, which receive faster priority include: investigations of a doctor engaging in sexual misconduct, practicing medicine under the influence of drugs or alcohol, or providing substandard care.

Key Considerations

In most states, there is a formal requirement for doctors and health care professionals, to report issues that might impact patient safety. This is known as a Duty to Report (.PDF), and includes issues regarding inappropriate or unprofessional conduct.

As a consumer, it is essential that you feel safe and secure in any medical interaction. A physician is a provider of care, working under the most stringent guidelines.

Assistance Club Summary

You deserve to receive professional care from your health care provider. If you feel that is not the case, take action and speak up. If you’re considering raising a complaint, it is good to know that specific governing agencies exist to protect your right for a standard of care. By following processes and guidelines, your complaint may not only benefit you, but also benefit your community.