1. If you're at a hospital and have a problem, ask for a patient advocate. Depending on the hospital's size they may only employ one person or could employ an entire department. The purpose of a patient advocate is to resolve CURRENT disputes with your CURRENT care. This doesn't apply just to surgeries. Patient advocates are there all the time for ANY reason.
3. When someone answers from that department, tell them you would like to send an email to their department about your care and ask for the email address you should send it to. Do NOT submit a problem after it has occurred under any circumstance using telephone. We also don't suggest doing it by letter. If you do submit your complaint by letter, make a photo copy of your complaint FIRST and send the letter by certified mail only.
4. Your complaint will be reviewed and you will typically be given a response by the department itself after it has conducted its investigation. If you disagree with the outcome of the review, email back and ask to be assigned to a specific person in the department so that you have continuity. Again, email is the best way for patients and hospitals to correspond so all communications are documented and available, for both patient and hospital, at all times. Each hospital will have it's own system for escalating your complaint. If you have reached the top and there is no resolution, you have multiple options depending on your circumstance and what happened.
a. You can learn from the experience, think about how you could prevent it from happening again in the future and then move on. When making this decision, think about how big your complaint is. Is it a mouse problem or an elephant problem? If it's a mouse problem, you've done what you could do and have notified the people at the hospital that need to know. Hopefully they will use that experience to make the experience of the next patient better.
b. If what happened is significant or you are especially concerned that it could be a continual practice, you can submit a formal complaint to The Joint Commission. You should take a minute to click on that blue link...it's not a link to their page but to one of ours that we think does a much better job of explaining who they are and what they do. There are TONS of misconceptions out there about this organization and it's time for these misconceptions to be corrected. We'll clear these misconceptions up when we can...we must prioritize.
c. If your complaint is about a licensed staff member, you'll need to submit a complaint to the state board that deals with the staff member's type of license. Typically, complaints are sent to a state nursing board or a state medical board (which is for any doctor).
To file a complaint, Google the name of your state + medical board. For example...
State Medical Board of Minnesota.
They will acknowledge your complaint through a letter stating they received it. Depending on the nature of the complaint, it can take months to years for the investigations to conclude. They won't tell you the specifics in their investigation but if there is a disciplinary action, the board will release it on their website after their board meeting. Not only can you verify a medical or surgical license on their website (as well as find out when they were granted), you can also view prior disciplinary actions taken. This is all public record.
Our suggestion is not to file a complaint on a doctor or surgeon unless they have violated a standard of care that is so egregious that it's ridiculous. Doctors and surgeons are humans just like you and me. They are going to make mistakes and that's just part of life. However, when/if they have done something (or more than one thing) that makes you worried about other patients in their care...that's when you need to consider it. Don't be a bully just because things didn't turn out how you wanted them. These are the livelihoods of other human beings who have put an enormous amount of time, money and experience to get to where they are. We have a good system of checks and balances in place. Don't abuse them or waste their time over something petty or accidental.
d. The TOP layer of oversite is CMS (The Center of Medicare and Medicaid Services).
Keep in mind, CMS is THE FEDERAL LEVEL OF GOVERNMENT. Any hospital that accepts medicare or medicaid can be held responsible at the government level because they are receiving government funds. This is the highest level there is and they are busy. They're purpose is to handle complaints that are broad in nature such as hospital insurance fraud. You don't go to CMS over a doctor or surgeon. That's what the state level of medical boards are for.
You do go to CMS when the rights of patients are being violated everyday and right now, they are. Current law only forces hospitals only to tell what surgery is occurring, not who will be performing it. Patients should have the right to know and give consent to ALL the who's that will be participating in their surgery, as well as their role, prior to surgery. That is TRUE informed consent. We have gone to CMS to demand change and we hope you do too.
Finally, if you're on this page, you might be desperate and looking for answers. We know how it feels. As Jack's mom, I went down a rabbit hole on the Internet looking for answers. It took months to find, piece together and solve the puzzle. No one handed these to us, told them about us or instructed us to this direction. But finally, after seven months of investigation, one web search leading to another, we found the key. They helped us solve our puzzle. Maybe they'll help you solve yours. Click the button below...CMS Rules...and be sure you read CMS' definition of physically present.
Ghost Surgeries, LLC. PO BOX 333 Milford, OH, 45150