Medical specialist - complaints process

Dear Jon01,

Thank you for your conversation. Why do you need the head’s of the clinic letter? Do you have a date by wich you expect your correspondence to be acknowledged? Can you set a reasonable date yourself? and state that your correspondence was not acknowledged. Can you do it electronically?

with kind regards

Maja

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Hi again,

The clinic director advised the letter (from the director) was sent to me last Thur. Normally it takes no less than 4 business days to get to me given the postman only delivers to me 2x a week.
Why did I write to the director? I always got further in my complaints if I copy the original letter to a 3rd party. That way, in this case, the doctor knows he can’t just fob me off because the director who rcvd a copy of the original complaint would expect some response to be forthcoming from the doctor.

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Hi Maja,

A f/u to my above post: the clinic director’s letter arrived today (taking over a week from one part of Sydney to another to get to me) mentioning:

(a) What I expected to read - that “each doctor sets his/her own fees and I cannot influence that”; and
(b) What I did not expect to read - if I believe that I received substandard care I “can raise it with the Health Care Complaints Commission” and their contact details were provided.

I will file a formal complaint and keep you (all) posted.

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Excellent! I assume, you are giing to post their reply. I thought about the issue, the medical practitioner’s behaviour is very questionable. You presented after 8 years of the previous presentation. He did not have your records, so he should have done a proper history, what he did not do. Based on the history he had to design a management plan, discuss it with you, the management plan should include the informed concent including the benefit and risk of any remediation.

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Thanks for your response. You’re conclusion is right, but not one assumption. He did have my records from years ago and noted them briefly, but made two errors. (1) He did not consider the implications and possible relationship of some of my previous symptoms to my current condition and (2) he assumed (in his letter to my GP) that I currently do not have certain symptoms which an investigation a decade ago ruled out. That is, without any tests or investigation he assumes that I currently do not have several symptoms.

These symptoms must be absent for him to reach the (mis) diagnosis he reached.

Anyway, I have filed with NSW Fair Trading a claim for a refund of that part of the fee that was not reimbursed by medicare. They indicated they presently have a 8 week timeline.
Tomorrow I will lodge my complaint with the HCCC. HCCC staff were most helpful when I called seeking guidance in what to focus on in my complaint.

Thanks again Maja.

Update

Medical specialist

  • NSW FT application is being looked at by FT staff (here I seek a refund for the out of pocket cost $230, given the physician breached Australian Consumer Law)

  • HCCC - my application is being looked at by HCCC given the physician offered a treatment based on his diagnosis which was made after he assumed I did not have certain symptoms but should have investigated the matter so he would know for sure whether I did or did not have those symptoms.
    Tests at another hospital proved his untested assumptions were false.

Update

Some good news.

As I wrote in early Sept, I complained to NSW FT asking for a refund of $225 being that part of the $460 I paid which medicare did not reimburse citing a beach of consumer law. I did not receive a diagnosis in accordance with the symptoms I presented. Instead, I received a treatment plan NOT in accordance with my symptoms. A plan I turned down. The good doctor in a letter to me rejected refunding me “any part of the $460”, citing he “did nothing wrong…merely acted in accordance with expected conduct of his profession”.

NSW FT just advised that in discussions with the good doctor that he has agreed to refund me the $225. No mention is made of when I will see the money.

My complaint about his unprofessional conduct is still being considered by the HCCC. Naturally I sent the HCCC the email from NSW FT advising of the good doctor’s change of mind.

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Update

On 7OCT21 NSW FT advised by email that the physician agreed to a refund for the amount claimed by me and that FT has now closed the case.

The same day I replied to FT asking:

  1. What time frame did the physician give FT in which the refund will be made; and

  2. In the absence of (1) above, does FT have a policy on what is a reasonable time in which to make the refund?

I received no reply.

I chased the matter up by phone today and was told: the physician gave no time frame and FT have no policy on what is a reasonable time frame. Before marching to NCAT, I was recommended to seek legal advice, which I declined citing the advice will cost more than the $225 I seek.

Looks like I will have to march to NCAT in order to secure the refund. Naturally I will sue for the NCAT fee as well.
I told FT that I will wait a month from when the physician agreed to a refund before applying to NCAT. If the refund is still unreceived a month later then it’s clear that no refund is forthcoming and that maybe the physician wanted to look good to FT by agreeing to a refund knowing his “agreement” will be noted in the case file as FT closed the case, irrespective of whether I ever saw the colour of his money.

Bottom line: reform is needed in how FT closes cases. Even though the complaint process is non binding on the parties, surely there must be consequences for misleading FT, as it seems the physician has done (by doing what he needed to to sweep the compliant under the carpet) or strict time lines must be introduced and applied by FT by when action by either party needs to have been undertaken if it was agreed to.

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Perhaps then name and shame the pyhsician.

It just might motivate him to pay up and it will help forewarn others.

He can hardly claim defamation when he has afreed to a refund, especially when he fails to honour such agreement.

Interesting you wrote that.
Independently of my FT action, I reported his conduct to the Health Care Complaints Commission, who as of last week, are still looking into the matter.

I suspect that personally naming someone, whether deserved or not, as a scammer or devious operator, would be subject to moderation on this site. And I would think that proper.

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Update

Fair Trading

A few days ago I called Fair Trading and told them that I have finalised my complaint to NCAT about the physician who told FT on 06OCT21 that he would refund me but to date has not done so. Naturally I am adding the NCAT fee to my claim, which I will file 4 weeks from 06OCT21.

Two days ago I received an email from the physician’s office advising that he will pay me the $225 I seek. Let’s see.

HCCC

Today I was informed by the HCCC that my matter was “considered” and no action will take place against the physician. “Consideration” involved taking note of the physician’s reply, which was not supplied to me as he did not want me to see it, but the HCCC stated that:

(1) The physician claims that his diagnosis was based on what I told him. (Of course the is BS. How can I tell any doctor if my legs move at night? Or if I snore? I could not possibly know) and

(2) In reply to my complaint that I was charged $460 and not $380 (as I was told), appartently the physician told the HCCC that the consultation was at least 45 mins long and hence more expensive than the usual consultation that costs $380. Also that a longer pricier consultation meant the m/care rebate was higher than would have been the case had it been a $380 consultation.

Again this is BS. The fact is when I booked to see him I had no idea what the m/care rebate would be. Only what his fee would be.
So he charged $460 (for a 45 min consultation) and m/care reimbursed me $235. He knew it was an initial consultation when I made the booking (M/care item number 132).

Given his diagnosis was worth little, I had to find another physician and start the whole intial consultation process all over again. That consultation also went for 45 mins (so the M/care receipt states, although I can’t recall how long it took). I was charged $370 by the second physician and M/care reimbursed me the same $235 so I was out of pocket $140.

I know little about the workings of M/care but know enough to realise that rebates are a function of item numbers (up to the scheduled fee) and is not a function how much a doctor charges.

It seems that the HCCC did not look too deeply into my complaint and they did not test the physician’s claims.

The HCCC offer me the opportunity to have their decision reviewed. I just got their email and am half keen on allowing A Current Affair to “review” it for me :slight_smile:

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Please see my posts on “oversight of Delivery of Professional Services”

Thanks for your post and pointing out the absence of powers Fair Trading has. In your case the situation could have been so very easily managed if your solicitor would have done what many do: that is say 3 months, maybe more, prior to their exit they should have alerted you and offered you the choices of retrieving your possessions, making arrangements with alternative solicitors etc.

I wonder if those who sit in judgment on tax payer funded authorities be they legal or medical have any non legal non medical folk on the panel or is is just mates looking after mates?

This post was written some 10 days ago and seems not to have been uploaded, so I am reposting.
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Further update

Fair Trading
The physician’s cheque arrived for the $225 I sought.

HCCC
Now I have to look into how to get hold of the physician’s response to my HCCC complaint which the HCCC will not share with me as the physician does not want it shared.

Seems like a bad joke. I allege unprofessional conduct; I have proof of symptoms the physician claimed I had which he could not know without a sleep study and that incorrect belief saw him rush to an improper Dx which then had him Rx benzodiazapines, yet his response to the HCCC cannot be seen by me let alone challenged by me.

Doesn’t seem right.