To whom, where and where should I write a complaint against the clinic doctor? Step-by-step instruction

Legislative framework

Proper care from medical professionals is not only the wish of the patient, but also a requirement of law and other regulations.

In carrying out their activities, doctors must be guided by:

• Federal Law No. 323-FZ of November 21, 2011 “On the fundamentals of protecting the health of citizens in the Russian Federation,” which contains the main responsibilities of medical workers;
• Code of Professional Ethics for Physicians of the Russian Federation – establishes certain rules of behavior and work with patients for doctors;
• Federal Law No. 326-FZ of November 29, 2010 “On Compulsory Medical Insurance in the Russian Federation” regulates the list of medical services provided to citizens free of charge;
• Order of the Ministry of Health and Social Development of Russia dated May 15, 2012 No. 543n “On approval of the Regulations on the organization of provision of primary health care to the adult population” regulates the activities of clinics and other medical organizations providing outpatient services, i.e. without placing the patient in a hospital.

Rights of the consumer of medical services

They are based on several laws, namely: on the protection of consumer rights (ZOPPP) and on the fundamentals of protecting the health of citizens (ZOOZG). The first legal act gives citizens the following rights:

• For safe services (Article 7);
• To receive reliable information about the doctor and the treatment, diagnosis, and rehabilitation provided (Articles 8–10);
• To carry out procedures and treatment on time (Article 27);
• To receive quality services (Article 29);
• On information about facts that affect the quality of medical care (Article 36).

In addition, in accordance with paragraph 2 of Article 12 of the Health Protection Act, the patient is given the right to use medical services without having special knowledge about their properties or characteristics. That is, the blame for choosing the wrong methods of prevention, treatment, and rehabilitation lies solely with the doctor .

If the Health Protection Act states the quality of medical care in the context of all services, this also applies to other areas, then the second law cited above directly affirms the right of patients to receive high-quality treatment (Article 2). This raises another problem - how to establish this quality. In this case, for lawyers and specialists who will conduct the examination, there is an order of the Ministry of Health dated May 10, 2017 No. 203n. They approve the criteria for assessing the quality of medical care.

For business entities that provide paid medical services, Rospotrebnadzor issued Information on January 2, 2018. The document concerns the protection of the rights of consumers of medical services and has a similar name.

Thus, the patient, as a consumer, is protected by several laws and departmental regulations. They make it easier for lawyers to protect clients from unscrupulous doctors. The latter perceived the fact of an increase in the number of criminal cases and satisfied claims against them as a deliberate action on the part of the authorities.

In practice, two trends are observed:

• Monetary claims against medical government institutions are reluctantly satisfied; the courts deliberately underestimate the amount of claims;
• It is difficult to win a case against private clinics due to competent legal support.

In both the first and second cases, patients are required to have legal literacy and many years of practice. They do not have it, so independently conducting a dispute with significant material demands on the clinic rarely ends in favor of the applicant and plaintiff. This cannot be done without the involvement of practicing lawyers.

If you are interested in the issue related to filing a claim for poor quality services, you can familiarize yourself with this material.

Dissatisfaction with staff performance

Violations of the patient's rights are expressed in the following actions on the part of the doctor:

• Providing poor-quality medical care due to the negligence of clinic employees, unlawful refusal to provide it;
• Failure to observe medical confidentiality, its intentional or careless disclosure;
• Refusal to hospitalize without any reason;
• Making an erroneous diagnosis;
• Incorrect course of treatment;
• Death, disability of the patient, deterioration of his health after medical intervention or refusal of help;
• Extortion of bribes, imposition of paid services.

In the United States, a quarter of a million people die each year due to medical errors. There is more mortality in medicine only due to oncology and cardiovascular diseases.

This is an incomplete list of what can cause complaints from patients against doctors at a medical institution. Rudeness, violation of ethics, and incorrect behavior are also the cause of complaints from patients.

In what cases should a complaint be filed?

If a doctor, through his actions or inactions, violates any of the above standards, he should be held accountable, especially if these violations lead to adverse consequences for the patient. Let's consider some specific situations of violation by doctors.

Refusal to provide service

The doctor is obliged to provide all necessary services if they are included in the list of services under the compulsory medical insurance policy. Thus, the therapist does not have the right to refuse to issue a referral to a specialist if the patient has the corresponding symptoms. Also, refusal to prescribe examination or treatment, motivated by the lack of necessary personnel, equipment or consumables, is unlawful.

In this case, the referral should be issued to an institution where it is possible to provide all the necessary services, and a complaint should be filed with the Ministry of Health and the insurance company about the unavailability of medical services in your locality.

Waiting too long for a doctor or long line at the clinic

Treatment must be timely: waiting too long to see a specialist can lead to serious health consequences. A long wait in line to see a doctor at a clinic is a difficult ordeal for a sick person. As a rule, standards for deadlines for patient care are established by the Territorial Program of State Guarantees for the provision of free medical care to citizens in each constituent entity of the Russian Federation.

Violation of these deadlines is a reason to draw the attention of higher authorities to this problem.

Low quality of medical care

When you visit a doctor, you can often find that he conducts a medical examination “for show”, neglecting his duties. It’s even worse when, as a result of an incorrect examination or the incompetence of a doctor, an incorrect diagnosis is made and treatment is prescribed, which not only does not help, but also aggravates the person’s health situation. In such cases, it is important not only to hold the doctor accountable, but also to demand compensation for the harm caused.

For this purpose, you will have to file a complaint about the incorrect diagnosis with the insurance company and the court.

Rudeness and insults from the doctor

This may not be the most serious offense on the part of a medical professional, but, nevertheless, the code of medical ethics considers such behavior on the part of a doctor unacceptable.

You can complain about a doctor’s unworthy behavior to the chief physician of a medical institution, so that he, in turn, can take disciplinary measures.

Disclosure of patient personal information

Maintaining medical confidentiality is one of the most important principles of the work of medical personnel. If a doctor shares data about your illness, treatment and other information with third parties without your consent, this is a gross violation of medical ethics. Depending on the consequences for disclosing medical confidentiality, a doctor may incur disciplinary, administrative and even criminal liability.

Extortion of a bribe

Medical institutions also cannot do without corruption: a bribe may be demanded for a scarce medicine, a valuable medical service, etc.

Of course, bribery cannot be ignored, and if you encounter it, you should immediately contact the prosecutor’s office.

Important! The article shows only some possible situations; the responsibility of doctors is not limited to them. If you have any doubts about whether there are grounds for a complaint against the doctor in your case, it is better to consult a lawyer.

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Documents for the complaint

Documents confirming the fact of violation of the citizen's rights are attached to the complaint. The list is given in the table.

What kind of doctor can be held liable?

If, during an inspection based on a complaint, the doctor is found to be guilty, then, depending on the severity of the offense, he will incur disciplinary, administrative or criminal liability. In some cases, financial liability is also possible.

1. Disciplinary liability can be in the form of a reprimand, reprimand or dismissal and, as a rule, is imposed by the management of the medical institution.
2. Administrative liability is imposed in accordance with the Code of Administrative Offenses of the Russian Federation and most often exists in the form of a fine. Any government agency that has the function of control over medical institutions, or its official, can bring a doctor to administrative liability.
3. In some cases, a doctor may also be held criminally liable: for causing death by negligence, causing grievous bodily harm, bribery, etc. The prosecutor's office and internal affairs bodies are authorized to prosecute cases.
4. The doctor bears financial responsibility only to the employer. The insurance company is responsible for compensating the patient for damages. Therefore, it makes no sense to demand compensation from the doctor for the damage caused to the patient in the complaint.

Liability of a doctor for negligence resulting in the death of a patient in 2022

We have already noted above that Article 293 of the Criminal Code of the Russian Federation establishes liability for the sloppiness of doctors. What do its norms imply?

So, if negligent actions resulted in death, then punishment is possible, both in the form of forced labor and in the form of imprisonment. In both cases, the maximum criminal penalty can be 5 years.

If a medical error resulted in the death of several people, then the maximum term of imprisonment can last 7 years.

In addition, a physician may be temporarily deprived of the right to practice medicine. The period of suspension from duties may be 3 years.

When determining the final penalty, both mitigating and aggravating circumstances surrounding death due to medical negligence will be taken into account.

Where can I complain about a doctor at a clinic?

In the event of an appeal against the actions of medical workers, the law does not oblige the patient to follow any sequence of appeals to government agencies: one can immediately choose the authority that, in the opinion of the citizen, can most effectively help in solving his problem.

Chief physician

However, in most cases, which, as a rule, are associated with inappropriate behavior of a doctor and minor offenses on his part, it is better to complain to the head of the medical institution - the chief physician of the clinic. The clinic's doctors are his subordinates, so he is authorized to consider citizens' complaints about their actions and, if necessary, take disciplinary measures. The chief physician is interested in preserving the face of his institution and not subjecting it to unscheduled inspections by regulatory authorities. The main thing is to indicate your intention to seek restoration of your rights, and the head of the institution will try to resolve the conflict that has arisen.

The head doctor personally receives citizens, but it is better to send a complaint in writing, which is an official request and cannot be ignored.

Ministry of Health

The Ministry of Health is the main authority exercising control over the provision of medical services under the compulsory medical insurance policy. The Ministry of Health considers almost any complaints about the work of medical institutions and is authorized to conduct inspections and investigations based on the circumstances specified in the citizen’s complaint.

Direct control over the activities of medical institutions is carried out by the regional ministry (department) of health. A citizen also has the right to appeal to the Federal Ministry of Health of the Russian Federation. We have already written about how to complain about a doctor to the Ministry of Health of the Russian Federation.

TFOMS

Doctors at clinics provide services provided for by the compulsory medical insurance policy. Therefore, territorial compulsory health insurance funds (TFIF) monitor the volume and quality of services provided by clinic doctors. Funds have the right to apply sanctions, including financial ones, to a medical institution that provides poor quality services to patients.

You can file a complaint against a doctor with the TFOMS in person, by mail, or use the electronic application form on the TFOMS website of your subject. Thus, the following contacts are available to submit an application to the Moscow Federal Compulsory Compulsory Medical Insurance Fund:

• hotline phone number;
• address: 127473, Moscow, st. Dostoevsky, 31, room 1A;
• electronic application form.

Insurance Company

You can complain to your insurance company, as well as to the Federal Compulsory Compulsory Medical Insurance Fund, about the quality of medical services, especially in the event of harm to health. It is the insurance company that is obliged to compensate for material damage to the patient in the event of the doctor’s fault.

The name of the insurance organization is indicated in the medical policy.

Roszdravnadzor

The Federal Service for Surveillance in Healthcare (Roszdravnadzor) is subordinate to the Ministry of Health of the Russian Federation and monitors the compliance of healthcare services with state standards. You can complain to Roszdravnadzor not only about the doctor, but also about the insurance company or the regional Ministry of Health if they did not respond to the appeal properly. Based on a citizen’s complaint, an investigation will be carried out, and if the doctor is guilty, he will be held accountable. There is a territorial branch of Roszdravnadzor in each region, and it is better to contact them there initially.

You can send an appeal to the Central Office of Roszdravnadzor in the following ways:

• hotline phone number;
• write a letter by mail: 109012, Moscow, Slavyanskaya Square, 4, building 1;
• submit an electronic appeal on the Roszdravnadzor website. Authorization through the ESIA will be required.

Prosecutor's office, police

If a doctor has committed a crime, you must write a statement directly to the prosecutor's office or internal affairs bodies. However, it should be understood that in order to bring a doctor to justice, strong evidence of his guilt is needed, without which contacting law enforcement agencies makes no sense. Thus, you can complain to the prosecutor’s office about a doctor if he demanded a bribe for the provision of medical services.

How to properly contact the Prosecutor's Office of the Russian Federation - read here.

Court

Basically, the need to go to court arises in connection with the need to recover moral and material damage caused by the actions of the doctor. But the claim will not be filed against a specific doctor, but against the medical institution as a whole.

What to expect from the prosecutor's office?

So, the complaint against the doctor is ready. In order to be accepted, you will need to submit documents to the department. You can do this in three ways:

• Contact the prosecutor's office assigned to your place of registration in person:
• Submit your complaint by mail . Be sure to use registered letters, otherwise your complaint may be lost in the mail;
• Submit your complaint with your representative. He must have a power of attorney from you, certified by the seal and signature of a notary.

Once your complaint is submitted, the proceedings will begin. A representative of the prosecutor's office will be obliged to interview these witnesses (if you reported in the complaint that they were present) and conduct an inspection of the organization itself. In addition, an employee of the prosecutor's office will contact you if necessary. If any offense or illegal actions are actually discovered in the work of a medical institution, the prosecutor’s office will take measures provided for by the current legislation and standards of work of medical institutions. You will be informed about the results themselves in a written official response.

How to file a complaint?

Regardless of where a complaint against a doctor is filed, the procedure for drawing up and filing it must comply with the norms of the Law on Citizens’ Appeals, and also take into account all legal nuances. Thus, even to an appeal drawn up in accordance with the norms of the law, you will receive a response if you do not provide convincing justification for your arguments. In addition, it must be remembered that the complaint will be read by ordinary civil servants who process many complaints a day, so the essence of the complaint should be stated as succinctly and concisely as possible. For the same reason, it is better to submit the application in typewritten form. When filing a complaint against a healthcare worker, you must adhere to the following sequence:

1. (for paper documents only) Application header. In the upper right corner of the document, information about the government agency receiving the complaint is indicated, and, if possible, the full name of the specific official authorized to consider the appeal on this issue. About himself, the applicant indicates his full name and address to which he wants to receive a response (postal or electronic). We also recommend that you provide your phone number so that, if necessary, government officials can ask clarifying questions about the complaint.
2. Document's name. It is written in the middle of the line and reflects the essence of the appeal (for example, Complaint about the inaction of medical workers).
3. The essence of the complaint. It is necessary to describe sequentially:
   when and to which medical institution and to which doctor the applicant applied;
4. what was the violation on the part of the doctor;
5. whether the violation resulted in adverse consequences;
6. if the applicant has already complained to other government agencies - what response to the complaint has already been given;
7. documents confirming the arguments of the complaint, for example, certificates of examinations and prescribed treatment, audio and video recordings;
8. norms of law confirming the presence of a violation in the actions of a doctor.
9. Requirements for the complaint. You can request to conduct an investigation and take action, prescribe treatment, issue free medications, etc.
10. List of documents that are attached to the complaint as evidence. Copies of documents should be attached, and the originals should be kept with you.
11. (for paper documents only) Date and signature.

Sample complaint

How to write a complaint to the prosecutor's office about the negligence of a doctor in the death of a patient

First of all, you need to decide with the prosecutor's office where to send the appeal. This can also be done at the place of residence of a relative of the deceased person.

The application itself should begin with a detailed description of the circumstances that led to the request for medical help (hospitalization, calling an ambulance to your home, visiting a doctor on an outpatient basis).

After this, the complaint to the prosecutor’s office about the doctor’s negligence must contain a reference to the person’s death. If its causes are already known, then you should write about them (improper treatment, drug overdose).

You can submit an application to the prosecutor's office regarding the actions or inaction of a doctor that led to the death of the patient yourself, but it is better to entrust this matter to a professional who has the necessary experience.

Next, we should describe the actions that formed the elements of the doctor’s alleged crime. In other words, it is necessary to indicate what exactly the negligent attitude towards the patient consisted of.

At the end of the application, you should ask to check the stated facts and take measures to initiate a criminal case.

Naturally, it is necessary to attach all medical documents confirming the visit to the doctor and the statement of the fact of death. The more there are, the easier it will be for the prosecutor’s office to make an informed decision on the further development of the case.

How to properly file a complaint?

To successfully file a complaint, it is important not only to draft it correctly, but also to submit it in a certain way. Proper filing will ensure that the complaint is accepted and properly considered.

1. To apply in person, you need to find out about the office hours of the government agency and, if necessary, make an appointment in advance. At the appointed time, you must come to the appointment with your passport, two copies of the complaint and copies of all documents that need to be attached. One copy of the complaint with attachments will be taken from the office for further registration and consideration, and the second will be marked as accepted. This copy must be kept as evidence of filing a complaint with the government agency.
2. By mail, a complaint with attachments can be sent to the department by registered mail with acknowledgment of receipt and a list of attachments. The period for consideration of the complaint will begin from the moment the letter is received by the department; the date of receipt will be indicated on the return receipt receipt. This method of treatment is the longest and is not suitable for situations that require a quick solution.
3. Many government agencies provide the possibility of electronic appeal on their websites. In this case, the application is drawn up by filling out the appropriate form, and the documents are attached in scanned form. Such an appeal will be considered in the same manner as submitted on paper, but you will not have to waste time visiting a government agency or sending a letter by mail.

Where to submit an appeal?

The completed complaint can be sent to different authorities - from the head of the department to the court (if filed in the form of a claim). It is recommended to start by contacting the head physician . For simple questions that relate to unsanitary conditions or boorish behavior, it is effective to leave a negative review on the institution’s website and forums and portals where information about the clinic is posted.

Appeal to the head physician

The management of public and private clinics is interested in reducing the number of complaints that are available to the public or have reached regulatory authorities. For chief doctors of budgetary institutions, this may result in disciplinary action and removal from office. Private clinics may lose income due to a decrease in clientele due to the spread of bad reviews.

You can make an appointment with the head physician or leave a written application through the secretary. A combined option is recommended: you must come to a personal conversation with a written complaint.

Online review

You can complain about the actions of a clinic doctor through portals and web resources of the city, region, or country. Just type “clinic No.__” in the search bar and indicate the city. In response, it will provide web resources that contain mention of this institution, its operating hours, staff, and where you can leave a review. It is drawn up arbitrarily and may repeat the text of the complaint.

There are precedents when doctors brought a patient to compensation for moral damages for a negative review online.

Therefore, the message you leave should:

• Be truthful;
• Supported by factual evidence.

This will help to avoid problems with the law and financial liability for the damaged reputation of a medical worker. This is especially true for private clinics, whose management may sue for compensation for lost benefits.

Terms of consideration

All of the above authorities, with the exception of law enforcement, consider appeals in accordance with Federal Law dated May 2, 2006 No. 59-FZ “On the procedure for considering appeals from citizens of the Russian Federation”:

• within 3 days the received application is registered;
• within 7 days from the date of registration, the complaint can be forwarded to another government agency if the topic of the complaint does not fall within the competence of the authority that received it. The applicant must be notified of such redirection;
• Within 30 days, the complaint is reviewed and a response is given. This period may be extended by another 30 days if it is necessary to request additional information or carry out checks. The applicant is also notified in writing of the extension of the deadline.

Patients versus hospitals: examples of successful court cases

1. The woman recovered compensation for moral damages from the hospital for the death of her mother due to poor quality medical care (case No. 2-693/2019). Only the appellate court made a positive decision in the case. At the same time, in the decision, the court emphasized that the patient is not obliged to prove a violation of his rights: on the contrary, it is the hospital that must prove that it conducted an incomplete study through no fault of its own.
2. The mother of a disabled child was denied life-saving medications. In court, she recovered the cost of medicines purchased with her own money and compensation for moral damage (case No. 33-8112/2019). Reimbursement for the cost of medicines was approved by the first court, and compensation for moral damage was recovered only in the appellate court. The court stated that the right to free medical products helps a person maintain a necessary standard of living. If it is violated, it threatens health and undermines the dignity of the individual.
3. A record compensation for the Russian Federation—15 million rubles—was paid to a patient for the death of a child that occurred as a result of doctors choosing the wrong tactics for childbirth (decision of the Primorsky District Court of St. Petersburg). The presence of a cause-and-effect relationship between the actions of doctors and the resulting consequences was confirmed by three examinations: from Rosgosstrakh, Roszdravnadzor and the Ministry of Health of the Russian Federation.

Legislation

The Criminal Code protects the rights of patients. Criminal liability is provided for:

1. Failure to provide medical care to a sick or injured person (Article 124). For this, not only the doctor, but also the nurse, the head of the institution, etc. can be punished.
2. Death of the patient (Article 109).
3. Damage to health due to unqualified treatment (Article 118).
4. An abortion performed by a person who does not have the appropriate specialization (Article 123).
5. Known danger of HIV infection (Article 122).
6. Illegal engagement in medical activities (Article 235).

This is not a complete list of situations falling under criminal law. In a specific case, you should seek advice from a criminal lawyer.

Sample complaint

Sample complaint about poor quality medical services

Filing a claim in court

Jurisdiction of claims is the district court at the location of the medical institution or at the patient’s place of residence.
The form of the document is strictly regulated, so it is forbidden to use colloquial expressions, insult the defendant, etc. It is important to provide not only references to legal norms, but also to attach a sufficient amount of evidence for each fact presented:

1. Agreement with a medical institution.
2. Receipts for payment.
3. Extract from the medical history.
4. Copies of prescriptions, prescriptions, diagnoses, diagnostic examinations, tests, etc.

Arbitrage practice

Litigation practice shows that careful preparation for the trial is the key to success. A plaintiff who knows the rules of the law or entrusts his defense to a lawyer has every chance to achieve the fulfillment of his demands. However, you should be prepared for the fact that the defendant also has legal resources and will be ready to protect his interests.

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Quality of medical care

According to Law No. 323-FZ of November 21, 2011 “On the Fundamentals of Health Protection...”, the quality of medical care is:

1. Timely medical care provided.
2. Correctly chosen method of providing the service.

Quality characterizes the degree of achievement of the set goal. In judicial practice, there are frequent disputes between patients and medical institutions due to the fact that the law does not focus on the correct implementation of the chosen method of treatment. In other words, if the prescription is correct, then this already indicates the correctness of the provision of medical services. There is no need to talk about guarantees of results (achieving the goal) due to the specifics of the healthcare industry.

When do patients usually complain? The most common cases:

1. Help was not provided in a timely manner or assistance was refused.
2. Misdiagnosis.
3. Negligence.
4. Too expensive appointments.
5. Rudeness and rudeness.
6. Damage to health as a result of treatment.
7. Wrongly chosen treatment method.

Forms of protecting patient rights

There are 2 forms of protecting patient rights:

1. Pre-trial (peaceful, claim).
2. Judicial.

The claim procedure within the framework is not mandatory. However, the court will certainly inquire whether the plaintiff tried to resolve the conflict peacefully. If this was done, it will be counted in his favor.

Not only the patient himself can defend the rights, but also on his behalf:

1. Representative (legal, by power of attorney).
2. Insurer representative (under policy or).
3. Prosecutor.
4. Ministry of Health
5. Public organization.
6. Rospotrebnadzor.