I have just finished an audit of written complaints made against doctors working at the Lower Hutt After Hours Medical Centre, which is staffed by shareholder GPs and contract doctors. It provides GP-level services after hours and, more recently, has also been open during the day.

There were 27,167 consultations in the year ending 30th June 2004. There were 21 written complaints, at a rate of 0.8/1000 consultations. Of the complaints, 11 could primarily be described as wanting a refund of fees after an illness had not settled as quickly as the complainant would like. Eight other complaints raised concerns regarding medical management, and could be described as more serious in nature.

It was interesting to note that doctors working the overnight shift were 6 times more likely to have a complaint made against them, compared to if they worked the day or evening shifts. They were also 8.5 times more at risk of getting a serious complaint made against them.

In 6 out of 8 of the more serious complaints, doctor manner was mentioned. A dishevelled appearance, lack of introduction, disinterested manner, or perceived rudeness counted against the doctor.

I suspect rates of complaints against doctors working in after hours medical centres are at least 5 times higher than if they were working in their own practice—as the doctor usually does not know the patient. Multiply this by 6 times more if working overnight.

Any perceived shortcomings of the doctor by the patient are less likely to be given the ‘benefit of the doubt’, and a good doctor manner and appearance are important in complaint prevention, especially overnight.

Overall, 99.992% of consultations were not complained about, indicating that overall we are not doing too badly. It would be interesting to know about complaints rates in other After Hours Centres, as I cannot find any information on this in the literature.