Communication failures lead to patient complaints


For immediate release: Monday, 11 March 2013

Doctors are urged to ensure patient safety is not compromised through instructions being misunderstood or misinterpreted, says UK-wide medical defence organisation MDDUS.

MDDUS figures from last year reveal that 20% of all medical contacts from members were in relation to patient complaints – making it once again the top reason for doctors to seek advice.

According to MDDUS Joint Head of Medical Division Dr John Holden, a number of these complaints could have been avoided with better communication between doctor and patient. “Doctors have a duty to discuss their patient’s condition and treatment options in a way that’s easily understandable so both parties can make decisions together,” says Dr Holden.

“MDDUS has dealt with a number of cases where unclear or ambiguous patient instructions have led to a complaint.”

For example, one such case handled by MDDUS involved a patient with gastrointestinal problems who was told by his GP to “come back if the symptoms got worse.”

“His symptoms persisted over several days but, because they had not worsened, he didn’t return to his GP,” adds Dr Holden. “This resulted in a prolonged illness and the patient went on to lodge a complaint against the GP.

“In this case, it would have been clearer if the doctor had advised the patient to come back within a given time frame, were the symptoms to continue or worsen. It helps to be as precise as possible. This is particularly important in cases that can change or progress rapidly, such as febrile illness in children.”

Recent research from London South University found that 43 per cent of people aged between 16 and 65 years unable to “effectively understand and use everyday health information.”

This highlights the need for instructions to be communicated clearly. “Doctors should remember that patients aren’t always familiar with medical jargon,” says Dr Holden.

“Advice regarding medication can be particularly confusing for patients. Some instructions can be open to interpretation so should be delivered to the patient in a precise way that is easy to understand.

“Patients who seem to be non-compliant may simply not fully understand the instructions issued by the GP. At the end of a consultation, a summary of any instructions given, whether it be treatment options or how often to take medication, may minimise errors.

“In patients with a record of non-compliance, be sure robust systems are in place to follow-up on their treatment to minimise the chance of missed appointments or non-communication of test results and so on.”

The need for clarity is heightened when doctors are consulting with patients by phone. “Doctors must satisfy themselves that a physical examination is not required and ensure the patient is clear about what they should do if things do not improve or deteriorate,” says Dr Holden.

“Ask more questions than normal, speak slowly and clearly and consider asking the patient to write down the details of any agreed management plan. If in any doubt, it is best to arrange a face-to-face consultation, including the opportunity to conduct a physical examination.”

GMC guidance Good Medical Practice states that doctors must “give patients the information they want or need in a way they can understand.”

The guidelines also highlight the need to “share with patients, in a way they can understand, the information they want or need to know about their condition, its likely progression, and the treatment options available to them, including associated risks and uncertainties. You must make sure, wherever practical, that arrangements are made to meet patients’ language and communication needs.”

Dr Holden concludes: “When giving patients advice or instructions, doctors must always make comprehensive notes reflecting what is discussed and the specific advice given. In the event of a patient complaint, medical notes may prove an important piece of evidence in the doctor’s defence.”


For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to

This page was correct at the time of publication. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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