Angry Doctor

Wednesday, March 14, 2007

The art of replying to complaint letters


Yesterday we featured Ms Lai's letter to the ST Forum on how her mother could not get an early appointment as a subsidised patient, but was offered an appointment the next day if she would become a private patient.

She asked: 'Does this mean that NHC would rather let an appointment slot reserved for private patients go unused than let a subsidised patient utilise the slot?'

The reply from the hospital is published in the ST Forum today. In this letter Dr Chua takes us through the number of referrals NHC receives each month, their system for triaging referrals, and the rationale behind it. He does not actually answer Ms Lai's question.

What really impressed angry doc, however, is Dr Chua's use of a single word which quite frankly could have been omitted, but whose inclusion put a sting in the reply. I emphasise the word in the letter which is reproduced below:

Earlier appointments for patients due for op

I REFER to the letter, 'Offer available 'private' slots to subsidised patients' (ST, March 9), by Ms Lai Howe Ling.

The National Heart Centre (NHC) receives requests for over 1,200 new outpatient referrals per month, a more than four-fold increase since it was established in 1994.

To cope with this high demand, NHC implemented a system for providing appointments, based on the urgency of the medical condition of the patients.

For patients with acute chest pain or suspected heart attack, our doctors work with the A&E Department to provide a 24-hour emergency angioplasty service to all patients, regardless of class.

For patients who do not have a cardiac emergency, but require earlier appointments because of suspected heart disease or the need for assessment prior to surgery, we routinely provide priority 'fast track' appointments within 2-3 weeks, based on the urgency and the date of surgery, as requested by the referring institution, and regardless of the patient's class.

Other patients who do not have such urgent requirements are given routine appointments.

According to our records, Ms Lai's mother was referred by the polyclinic to NHC for asymptomatic ECG findings, hence a routine appointment was given.

(A recent study by NHC showed that for patients with such findings, the likelihood of significant heart disease was very low.)

We were initially not aware that the patient was going for an eye operation at a private hospital, otherwise an earlier appointment before the operation date would have been given.

Subsequently, when Ms Lai contacted us, our staff overlooked the possibility of using the priority appointment system for pre-operation assessment. (Normally the hospital doing the operation would call our staff for an early appointment).

We apologise for this lapse. We have contacted Ms Lai and were informed that her mother is fine and would be going for the eye operation at the end of the month.

We would like to highlight that it is not our policy to request patients to upgrade their class status to get an earlier appointment date, as there is a system to ensure fast-track appointments for subsidised patients for urgent referrals and pre-operation assessment.

Dr Terrance Chua
Deputy Medical Director
National Heart Centre




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