‘We're gonna end up scared to do anything’: A qualitative exploration of how client complaints are experienced by UK veterinary practitioners

Abstract

Background: UK veterinary practitioners are reported to be fearful of client complaints, but their experiences have not been formally captured. Understanding how complaints impact veterinary practitioners is key to mitigating detrimental consequences. Methods: A qualitative exploration of how UK veterinary practitioners experience and respond to adverse events was conducted. Data were collected via focus groups and interviews, which were transcribed and simultaneously analysed. Coding and theme development were inductive rather than restricted by preconceived theories. Results: Twelve focus groups and 15 individual interviews took place. One theme identified focused on the impact of client complaints. Practitioners experienced unintentional distraction and disengagement from clinical work, as well as employing defensive strategies as a direct result of complaints. The vexatious nature of some complainants was highlighted, along with concerns about practice and regulatory complaint management, lack of appropriate support, discriminatory behaviours and the influence of 'trial by media'. Conclusions: Client complaints present a threat to practitioner mental health and workforce sustainability, as well as having implications for patient safety. Mitigating these effects is a complex and multifaceted undertaking, but fairness, transparency and timeliness of practice and regulatory complaint investigation must be prioritised, along with provision of tailored support for those facing complaints.

Managing client complaints: identifying and mitigating their detrimental impacts on veterinary practitioners

“…10 Gibson and colleagues also found that the emotional burden of client complaints could be exacerbated by practice-and regulator-level complaint investigation and management processes. 7 In particular, the administrative burden associated with investigations and the perception that staff were 'guilty until proven innocent' were identified as key potentiating factors. Participants also reported that the adverse impacts could be influenced by the level of support provided by colleagues and practice managers.…”

“…6 Similarly, in a paper summarised on p 160 of this issue of Vet Record, Gibson and colleagues highlight the utility of client complaints for identifying patient safety issues, particularly those at a system level. 7 However, learning opportunities aside, complaints, particularly those perceived to be malicious, were found to be linked to adverse emotional effects such as anger, fear, frustration and a reduction in clinical confidence. 7 These themes are mirrored within the human healthcare literature, where general practitioners described feelings of intense anger (sometimes directed at the patient) or depression (often linked to concerns about clinical ability) after receiving patient complaints.…”

“…7 However, learning opportunities aside, complaints, particularly those perceived to be malicious, were found to be linked to adverse emotional effects such as anger, fear, frustration and a reduction in clinical confidence. 7 These themes are mirrored within the human healthcare literature, where general practitioners described feelings of intense anger (sometimes directed at the patient) or depression (often linked to concerns about clinical ability) after receiving patient complaints. 8 In addition to the emotional effects they experienced, participants in Gibson and colleagues' study also identified a number of adverse professional impacts arising directly from client complaints.…”

“…These included distraction at work, engaging in defensive practice and avoiding specific clients or procedures by leaving particular cases for colleagues. 7 In some cases, the experience of client complaints precipitated a change in role, leading veterinarians to alter their career focus or practice type. A similar trend was also reported in a study examining the impact of complaints on veterinary support staff, where 26.5 per cent of respondents reported considering a career change following client complaints.…”

Learning from patient safety event reporting in veterinary practice

“…The distress that can result from feeling responsible for harm to a patient can be considerable, 1 and reputational damage, or fear of it, can also have a negative effect on veterinary professionals' mental health. 2 In addition, there is also a financial burden on the practice due to costs involved in mitigating or rectifying the harm, lost time in dealing with the incident and damage to the relationship with the client. 3 The aim of patient safety systems is to prevent and reduce risks, errors and harm that occur during healthcare provision.…”