Image: iStock.com/Parradee Kietsirikul
Dr Victoria Cox explains that staying resilient following a complaint requires noticing what is and is not in your control
Providing healthcare and caring for people often at their most vulnerable means that complaints are almost inevitable and even the most experienced of healthcare professionals will one day find themselves the subject of one. In 2024, Medical Protection assisted members in Ireland with over 150 complaints.
Being at the receiving end of a complaint can be distressing – whether it relates to clinical care, manner, or conduct. Doctors may feel disillusioned, particularly if they felt the interaction with the patient was positive. Receiving criticism can also be frustrating, as doctors are doing the best they can with the time and resources available.
There may be a concern that the matter will escalate to a claim, disciplinary procedure, a referral to the Medical Council, or even a criminal case. So how do you manage the stress and anxiety associated with receiving a complaint?
Complaints can quickly snowball, adding significant pressure to clinicians. This stress is often heightened by the tight deadlines to respond before there has been adequate time to fully review and address the key concerns raised. In Ireland, while there is no prescribed timeframe for responding to in-house complaints, best practice is to provide a timely response to prevent escalation or further dissatisfaction. The complainant should be informed that their concerns are being investigated and a timeframe offered as to when they can expect a response. This should not be so tight that a doctor is under undue pressure to respond before fully reviewing the complaint, but also not so far in the future that the complainant feels their concerns are not being addressed.
Many clinicians will never have written a response to a complaint before and it can be overwhelming. An early request for assistance from your medical defence organisation (MDO) can make all the difference, both in formulating a response and for general support. Several drafts may be required before the response is ready to be shared with the complainant, so early contact will allow sufficient time and help to alleviate some of the stress. Clinicians may also want to seek the assistance of a more senior or experienced colleague, supervisor, or manager who may be more familiar with the complaints process.
The aim of a good complaint response is to de-escalate the complainant’s concerns and prevent an onward referral to the Medical Council. A conciliatory tone should be adopted when responding to a complaint even if it is felt to be unjustified. There is often a reluctance to offer an apology or even reflect on a complaint for fear that this is considered an admission of error, raising the risk of litigation. However, this simply is not true. Reflection and remediation are key components that are expected to be demonstrated in a complaint response by reviewing bodies. It is extremely important that both individuals and organisations take the time to address this key area in a complaint response and look at what can be done differently to prevent something similar happening in the future. Many patients really do just want an apology and reassurance that similar incidents will be prevented in the future.
A complaint case from the Medical Protection files shows how reflection and a carefully considered response can de-escalate a situation effectively (see panel).
Summary
Complaints can arise unexpectedly or may be anticipated when a patient’s care does not go as planned. Nevertheless, they can be stressful and add to the burden of the day-to-day job. To assist with managing the stress and anxiety that comes with answering a complaint:
▶ Set a realistic timeframe to respond to the complainant. Discuss this with any colleagues who may be responding to the complaint on your behalf, taking into account your clinical duties and any pre-booked leave.
▶ Contact your MDO early so they can assist you with drafting a complaint response in the required format.
▶ Read the complaint thoroughly and spend time picking up the key areas of concern and address them in your response. This will demonstrate to the complainant you have properly read and understood their concerns.
▶ Spend time reflecting and document clearly any learning undertaken. Explain if any policies or protocols have been amended or written as a result of the complaint.
▶ Be apologetic and acknowledge any distress that may have been caused, even if you feel the complaint itself is not justified. Doing so may avoid an escalation of the complaint if you have demonstrated insight and reflected on and remediated the
issues raised.
▶ If possible, offer to meet with the complainant face-to-face. Whilst this may feel awkward many patients appreciate the offer from a clinician to set aside time specifically to discuss their concerns and many complaints are de-escalated with this approach.
While stressful at the time, when handled well complaints can lead to better doctor-patient relationships, improved clinical systems and more insightful clinicians.
Continued learning
Staying resilient during a complaint is not about gritting your teeth. It is about noticing what is and is not in your control, pausing some of our instinctive reactions – like feeling angry and defensive, or overly self-critical or guilty that can spiral after criticism, and choosing responses that protect both patients and your own wellbeing.
A free Medical Protection webinar on 26 March 2026, led by the team at Wild Monday, will focus on practical ways to manage yourself through complaints and difficult feedback to avoid burning out or making things harder than needed. It will cover how to:
1. Spot and shift unhelpful self-talk after a complaint;
2. Regulate your stress response in the moment so you can respond rather than react;
3. Set realistic boundaries, seek support early, and maintain perspective while the process unfolds;
4. Reflect and remediate with self-compassion, turning learning into safer systems and practice.
The webinar is one of a series of three supporting doctors to reduce stress and avoid burnout. Medical Protection members can log into their Prism account to register:
How to stop the slide into burnout – https://prism.medicalprotection.org/mod/page/view.php?id=17079
How to support your colleagues without burning out yourself – https://prism.medicalprotection.org/mod/page/view.php?id=17094
How to manage yourself and stay resilient during a complaint – https://prism.medicalprotection.org/mod/page/view.php?id=17109
Case Study
Dr X, a salaried GP, saw a 58-year-old female who was concerned regarding a skin lesion on her left arm that had changed colour. Despite colleague sickness and an overrunning morning clinic, Dr X took a history, examined the patient, and spent time reassuring them that the lesion was benign. Subsequently the patient sought a second opinion through a private health scheme and was diagnosed with a malignant melanoma resulting in the patient undergoing extensive surgery. The patient wrote to the practice to express their disappointment with Dr X’s attitude on the day, explaining that they felt rushed and that Dr X did not examine the lesion properly. Consequently, the patient felt that the delay in diagnosis had resulted in them requiring more extensive surgery and this had resulted in significant anxiety and stress.
Dr X had never received a complaint before and, despite being under extreme pressure on the day in question, felt that the consultation had gone well and was disappointed to learn the outcome for the patient. He was also extremely concerned to learn that the complainant had threatened to refer him to the Medical Council.
Dr X contacted Medical Protection and sought assistance to draft a complaint response. He was advised that a key area to consider for reflection was his misdiagnosis of the skin lesion and how he could demonstrate additional learning or training in this regard. He undertook additional dermatology training both online and in-person. Dr X considered the pressure he was under on the day of the consultation and how this might have appeared to the patient. Dr X thought about what he could do if placed under the same stresses again. After conducting a serious event analysis, the practice agreed a protocol to initiate when staffing levels became critical or clinics were running substantially late to relieve the pressure on single clinicians. Dr X felt reassured that the practice acknowledged that there were systems issues that contributed to the complaint as well as his own actions.
Dr X offered to meet with the patient to go through the complaint response and following the meeting the patient agreed that their concerns had been satisfactorily answered. More reassuringly, the doctor-patient relationship was maintained and Dr X has continued to assist the patient
with their recovery.
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