Depending upon where the incidents occurred and who was responsible, complaints can be filed to any of the following. There is no time limit on these complaints -- however, the sooner after the incident, the more effective the complaint. Your first action should be to request all of the medical records from hospitals, doctors, and other agencies and facilities involved. They will require a small copying fee. Keep copies of all complaints you file, letters you receive, and records of phone calls with these organizations.
State Medical Board
The medical board oversees the practice and licensure of physicians. Write a letter of complaint about the care of a specific physician listing examples of when the patient was in pain (what the patient said or did to indicate the pain), steps taken to reach the physician, what was said or done. State the facts clearly and succinctly. Keep the letter to two pages, if possible. If you want, find another physician willing to write an opinion about the poor care the patient received. (This physician will want to see all of the patient's medical records.) Include that opinion with your letter to the board. The board should investigate your complaint and notify you of the results. This investigation may take several months.
Medicare has two types of complaints -- for fraud and abuse which go directly to a special "hotline" and for "provider (physician) care" which are directed to the PRO -- Peer Review Organization in each state. The complaint can be exactly the same as the complaint to the medical board (see above).
State Nursing Board
The nursing board oversees the practice and licensure of registered nurses. As with the medical board, write a letter of complaint about the care of a specific nurse, list examples of the nurse's behavior toward the patient, what was said and done. The board should investigate your complaint and notify you of the results.
JCAHO (Joint Commission for Accreditation of Health Care Organizations)
This organization evaluates hospitals, hospices, home care agencies and some outpatient clinics every two or three years. Most, but not all organizations are "JCAHO Approved" meaning they volunteer to be surveyed. To see if the facility is evaluated by JCAHO -- call the main number and ask for administration. For those that are surveyed, a good "score" from JCAHO means that they can receive payment from Medicare. JCAHO recently developed strict standards for the management of patient's pain, and take this issue seriously. Physicians are not evaluated by JCAHO.
Hospital, Nursing Home, other Long-Term Care Facility
Write a letter to the administrator asking in strong terms that the care of the patient be investigated at the highest level. List specific examples of when the patient's pain was ignored, medications not given, physicians not called, etc. If you have filed other complaints (as above) include that information in your letter of complaint. Ask the administrator to fully investigate the case and to let you know the results of the investigation. Ask them to institute policies and procedures and education programs for physicians and staff regarding pain management.
Long-Term Care Ombudsman
Every state has an Ombudsman's office which oversees the care at long term care facilities. In addition to writing a complaint to the facility, send a copy to the Ombudsman and let the facility know you are doing this.
Write a letter to the Director of the Hospice Program, asking in strong terms that the care of the patient be investigated at the highest level. List specific examples of when the patient's pain was ignored, medications not given, physicians not called, etc. If you have filed other complaints (as above) include that information in your letter of complaint. Ask the administrator to fully investigate the case and to let you know the results of the investigation. Ask them to institute policies and procedures and education programs for physicians and staff regarding pain management.
Specialty Clinics (Dialysis, Cancer Care, Etc.)
Write a letter to the administrator or director (as above under hospitals, etc.)
Contacting an Attorney
In some cases and in some states it may be possible to file a legal claim under the Elder Abuse statute, or for Medical Malpractice. To find an appropriate attorney, talk with friends and colleagues and call your State Bar Association. Cases for legal action have time limits in which to file -- usually one or two years after the death of the patient. The attorney will need to see the patient's medical records. You can file the other complaints listed above while you are considering a legal case, or looking for an attorney.
Contact State Legislators
If you file a complaint to the medical board or hospital as above, send a copy to your elected representative and local state senator. Many states are considering legislation to improve pain care and lawmakers need to know the kinds of problems citizens are encountering. To learn the address of your representative, call your state's major newspaper or the Assembly offices in the capital city of your state.
Pain is a big topic of discussion in communities right now. Contact the health editor or health reporter of your local newspaper, and ask them if they might be interested in writing a story about how pain in your community is still being under-treated.