How to file a grievance against a doctor in the USA

A reader writes:

I work as the person who handles complaints for a mid-size hospital with clinics and outlying facilities in the midwest, and I want to make sure that the people on your site (since I myself am large and have experienced the discrimination against fat women) have what they need to truly get effect.

* If it happens in a clinic or doctor’s office, find out who the doctor is employed by. Perhaps the doctor is self-employed, but perhaps not. If he has admitting privileges at a large local hospital, he may well be employed by that hospital.
* If it happens at a hospital, (and this is important to do word for word) ask for the house officer/supervisor to make a formal grievance. The important word is “grievance.”
o Once this is filed, this initiates a chain of events that is overseen by CMS (Center for Medicare/Medicaid Services). This chain of events should happen EXACTLY, or the hospital can be fined or lose its ability to take Medicare EVEN IF THE PATIENT IS NOT ON MEDICARE!
+ A letter should be sent within 7 days acknowleging the grievance.
+ A follow-up letter should be sent every 7 days thereafter until there is a resolution.
+ A resolution letter closes it out with their investigation and findings.
* What should you do if any of this does not happen as it should?
o Send a letter to CMS.
o Send a letter to the local state health department. (Their regulations will differ by state, but they have more people to go and show up at the hospital and talk to someone.)
o Send a letter to the TJC. (Formerly, JCAHO…The Joint Commission)
* Whether or not this has satisfied you, send a letter to your insurance company. They also tend to investigate, because delayed medical treatment raises their costs.

Battling medical bullies has a story out today on ‘medical bullies’ – medical professionals who browbeat patients, ignore questions, act impatient, insult patients and/or colleagues or even yell, cuss and throw things.   Now the Joint Commission, a national hospital accrediting agency, warned that there’s mounting evidence that such disruptive behaviors are tied to medical errors that can cause patient harm — and called on hospitals to adopt a no-tolerance policy.

Starting in January, the agency will require hospitals to establish codes of conduct that define inappropriate behaviors and create plans for dealing with them. Suggested actions include better systems to detect and deter unprofessional behavior; more civil responses to patients and families who witness bad acts; and overall training in “basic business etiquette,” including phone skills and people skills for all employees.

The AMA has had a policy calling for zero tolerance for disruptive behavior for all workers for years.  The Joint Commission standards and suggestions will offer hospitals a clear model for establishing guidelines and consequences that will help decrease disruptive behavior.  Official warn that it could take years however for a major culture shift.

The MSNBC story includes a sidebar on bullying behaviors.  How many reader submissions featured here echo the very same behaviors listed?

Welcome WFPL listeners

Welcome listeners of Louisville-based radio station WFPL 89.3.  If you’re accessing this site in response  to the State of Affairs segment today on fat acceptance and weight-based discrimination, here’s an introduction.  The site was conceived after a blogger wrote a three-part special entitled Fat Hatred Kills.  The response to Thorn’s poignant story was an onslaught of similar stories of weight-based discrimination in health care.  This site strives to provide an outlet for people to share their experiences with hopes the stories will prove to be self-empowering and work to change the discriminatory landscape prevalent in too many doctor’s offices and hospitals.

The stories here are heartbreaking in their brutal honesty: Scores of fat people denied adequate and competent health care from medical professionals who couldn’t see past their fat to diagnose and treat the problem.  This is, in fact, one of the primary reasons why more fat people don’t go to the doctor until, in some cases, it’s too late – they don’t want to be bullied by those who’ve taken an oath to “First, Do No Harm.”

This site was borne as a way for people to speak out about the discriminatory treatment they’ve received.  If you’ve been the victim of fat-discrimination in health care, find out how to lodge a complaint here or send us your story here.   You are not alone.

You’re too fat to have surgery

This isn’t an emailed submission, but it’s definitely relevant to the scope of this site. An article, “Where Fat Rules Out Surgery,” reported today in the Monterey Herald reveals a growing trend in the numbers of patients being denied nonessential surgeries by British health authorities because of their weight.

For two years, Frances Kinley-Manton says she lived with arthritis pain in her hips, a condition that kept her in a wheelchair. She wanted hip replacement surgery. But doctors at Britain’s National Health Service said she was too fat for the operation

Read more…