A procedure for handling complaints against general practitioners.

Patient dissatisfaction with the care they receive in general practice is sometimes expressed as a formal complaint. We report our experience with an hierarchical complaints procedure. The annual rate of complaints received by the area medical director of a local health centre serving 11 500 patients was 100 per 10 000 registered patients. The medical officer for the region (regional population 160 000) received 4 complaints per 10 000 patients. The regional Public Complaints Committee received 0.1 complaint per 10 000 patients per year and the Israeli National Health Service Ombudsman received 0.2 complaints per 10 000 patients per year from the same region. Almost all dissatisfaction relating to style of practice was dealt with at the local level, while complaints relating to matters of substance or ethics quickly reached the higher authorities. The complaints procedure was thus shown to distinguish between temporary breakdowns of the doctor-patient relationship and inadequacies of the system of care and to handle the relevant complaints appropriately.