How to Complain
Q: My mother came
home today from a 16-day hospital stay. There were many problems with the facility,
varying from total neglect to abuse. Where does one make a formal complaint above the
hospital administration level?
A: Its unfortunate your
mother had such a bad experience in the hospital. There are several agencies that oversee
hospital care, and you can certainly file complaints with them. But in reality you can
probably make the biggest impact on the institution by making your concerns known to top
management. After all, hospitals are big business these days, and they want to keep their
customers also known as patients happy.
say whether you or your mother made complaints while she was still hospitalized. There are
some things you can do at that point, such as taking your concerns to the nursing
supervisor, if your worries were about nurses or aides. Most hospitals also have a person
on staff known as the patient advocate, who will intervene to resolve problems on behalf
of patients. Most disputes arise because of poor communication, so having a third party
come in to listen to both sides can resolve things pretty quickly.
If you don't get satisfaction from those staff
members, then feel free to go directly to the hospital administrator, recommends
health-care consumer advocate Vincent Riccardi, M.D. He says the hospital administrator is
probably not aware of specific lapses in care, and in fact may be shielded from them
because of the institution's bureaucracy. And yet, the person on top is the most
interested in ensuring that the business is run well. "The hospital business is so
competitive now," Dr. Riccardi notes. "The last thing these guys want is grief
from an unhappy patient" jeopardizing their insurance contracts.
The best way to communicate your concerns is in a
face-to-face meeting with the administrator, Dr. Riccardi says. "That is the best way
to really have an impact, and they'll listen," he suggests. If you can't get in to
see the administrator, write a letter directly to that person.
If you're unsatisfied with your audience with the
hospital's top bureaucrat, find out who owns the hospital and contact that company or
organization. That could be a large national for-profit chain, a religious organization or
a local government agency.
Continuing up the medical food chain,
another way to get your criticism heard and acted upon is to follow the money: Take your
complaints to whoever is paying the bills. If your mother is over 65 or disabled
and on Medicare, then
try calling the local Medicare counseling service. You can get a referral to your local
office by calling (800) 638-6833.
If your mother's insurance is through an insurance
health plan, let its administrators know about your troubles. Also, if the coverage is
ultimately purchased by an employer, take your comments to the human resources department
of the company. At the very least, the employer should know whether it's getting good care
for the dollars it's plunking down in health benefits.
There are also government agencies out there that
oversee hospitals, and you can certainly file a complaint with them. Generally the
hospital gets its license from the state health department, which would take any
If you have a serious complaint against an individual
licensed professional, such as a nurse, doctor or anesthesiologist, you can take that to
the state licensing board for that profession. Call the particular board to find out how
to file a written complaint.
Another group overseeing hospitals is an organization
called the Joint Commission
for the Accreditation of Healthcare Organizations. The joint commission sends out a
team every three years to inspect the way hospitals are run and then rates them on their
procedures. Losing Joint Commission approval can cause a lot of trouble for a hospital,
because many insurers including Medicare require that hospitals be
accredited before they'll pay the bills. Still, the JCAHO isn't that open to consumer
complaints unless something really bad happens like a death or serious injury
in which case you could certainly inform the Joint Commission. The phone number is
Always remember that when youre
in the hospital its your choice if the situation is really bad you always
have the option of going elsewhere, assuming your health is stable enough to do so.
Talk to your attending physician if you can't get the problem resolved while you're
Also, keep in mind that most U.S. hospitals
voluntarily abide by a Patient Bill of Rights, which says that patients have the right to:
|Receive considerate and respectful care
|Be well-informed about their illness, possible
treatments and likely outcomes, and to discuss this information with their doctor
|Know the names and roles of people treating
|Consent to or refuse a treatment
|Have an advance directive, such as a living will
or health-care proxy |
|Expect that treatment records are confidential
|Review medical records and have the
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