Not texting

BACKGROUND: A letter of complaint is received by a practice manager (PM) from the mother of a two-year-old girl – Zoe – who attended the surgery suffering with an earache. In the letter the mother – Mrs G – complains that the attending GP – Dr L – did not provide adequate treatment for her daughter and showed a lack of regard for her concerns, at one point in the consultation reaching for her smartphone to text someone.

The PM pulls the patient’s files and speaks with Dr L to investigate the claim.

She learns that Mrs G had phoned the surgery that previous Monday morning requesting an emergency appointment. Zoe was seen by Dr L who first took a history. Mrs G told the doctor that the child began to complain of an earache on Friday and by Saturday she was in constant tears with the pain. Mrs G took her to A&E on the Saturday night, was given amoxicillin and told to attend her GP if Zoe was still in pain.

That Monday she attended the GP surgery and stated that the medication supplied by A&E had not worked. She had looked up middle ear infection on the internet and insisted that the GP prescribe a different agent. It was at that point Dr L reached for her smartphone but it was not to text. There was no record yet of an A&E attendance in the medical notes, so she wanted to check if information had been received electronically but not yet filed. To do this she needed to retrieve her username, which she kept stored under password protection on her smartphone.

Checking the record from A&E she then examined Zoe and noted inflammation in the ear canal and some discharge. She advised Mrs G to persist with the amoxicillin in addition to ibuprofen and paracetamol. She also explained that most ear infections clear up after a few days without need for antibiotics. Mrs G seemed to accept this advice.

OUTCOME/ANALYSIS: The PM contacted MDDUS who provided advice regarding the letter of response to Mrs G’s complaint – making special mention of the fact that Dr L had not been texting during the consultation. It was suggested that Dr L contribute wording to justify her treatment decision, citing evidence on the efficacy of antibiotics in the treatment of otitis media and current guidance.

It was also suggested that the letter include a statement of regret saying that Dr L was sorry if Mrs G felt she was not paying sufficient regard to her concerns. The PM offered to meet with Mrs G to discuss the matter if necessary – and provided contact details for the ombudsman in case Mrs G wanted to take the complaint further.

The practice hears nothing more in regard to the complaint.

KEY POINTS

• Consider what actions taken during a consultation might lead to misunderstanding.
• Ensure that you can explain clinical decisions in such a way that a patient without a medical background can understand.
• An apology or expression of regret at patient dissatisfaction can often defuse a complaint.