Managing patient complaints in dental practice in Brazil: the potential role for Mediation

Abstract

A complaint has been described as an expression of dissatisfaction whether justified or not. There are many reasons why patients complain against dental practioners: wrong treatment or poor treatment; poor communication between patient and the dentist; dentist not make clear how much the patient have to pay for treatment; faulty procedures; the dentist is being unfair or biased; when the dentist is being rude or not apologising for mistakes. Like all medical professionals, dentists have to work in accordance to the legal regulations in their countries and to ethical principles. And in case of conflict, the mediation should be mentioned as an alternative which empowered the parties involved in the conflict. It is more practical, cheaper, quicker and confidential, not just reduce the legal costs but also time and waste of energy. In Brazil, Mediation was recently regulated according the Mediation Law 13140/2015. The main objective of this research is identify if Mediation has a role in managing patients’ complaints in dental practice in Brazil and the secondary objectives are calculate the percentage of patients’ complains regarding their care or treatment performed by Brazilian dentists nowadays and also Identify what are the common issues that are the subject of patients’ complaints. Brazilian dentists colleagues were contacted by social media (Facebook, Instagram, WhatsApp) and by e-mail. They were asked to participate in the current research answering a online form designed by the researcher about patients’ complaints and mediation. The data collected were stored in an Excel spreadsheet, they were submitted to descriptive analysis of each variable and put them back in an Excel application system in way that the researcher could access all results without identifying each response with their respective participant. A total of seventeen people agreed to participate in the research. They have completed the form, of whom 65% was composed of women, with 35% of men, 35% of the interviewers have up to two years of professional experience, 29% of the sample have between 2 and 5 years of experience as dentist, 12% of the dentists have between 6 and 10 years of experience or between 21 and 30 years. Also 6% of the interviewers have between 11 and 20 years of degree or 30 years or more of experience. Regarding to the their work fields, 82% of the professionals work as liberal professional, meanwhile 12% work in Popular Dental Clinics and 6% in the Public service of health. The majority of participants are dentists level 7, in other words 47% 6 are not specialist, or have done a master degree. Six dentists (35%) suffered from up to two complaints in their whole professional career, four dental practioners (24%) had received between three and five formal complaints addressed to them. Also 24% of the dentists had between six and ten complaints and only one dentist said that had more than ten complaints during his/her dental career. 35% of the complaints analysed were dissatisfaction with the final results, which is directly correlated with the patients’ expectation, 18% of the cases were regarding to treatment lasts and also 12% were in relation to the presence of pain after treatment. 24% of the interviewed answered that they redid the treatments without extra charge, on the other hand 18% of those had refunded the whole amount paid. 12% of dealings with patients include a refund of partial amount paid. 71% of the interviewers recognise Mediation as an alternative method to solve conflicts. I conclude, based on the findings that the most common issue that patients complain is when they are unsatisfied with the final results of treatments. I could conclude also that formal complaints to dental practioners or to agencies with specialised service are not the first action regarding to Brazilian patients’ behaviour since in Brazil the relationship between dentist and patient is still in most of the cases based in confidence and trust and it is not considered as a commercial service, despite of the fact that, according to the Brazilian Civil Law dentists are a producer of service. Besides that, it is noticed that in several articles used to base this dissertation the increase of number of complaints in Brazil are complaints to Popular Dental Clinics most recently created where the quality of the service is in second place comparing to the income and in those cases there is a trademark facing a group of professionals hired to treat as many cases as possible. Most of the dentists interviewed are working as liberal professionals so that it is likely to find that most of the participants had only few complaints through their career and when they complain the most common reason is dissatisfaction with final results which resolution is through communication and treatment redone.