Other Places to Find Help
Many people do not know where to go and who to turn to when a health care problem arises. Remember there are other individuals like you.
Use the diagrams below to figure out where to turn and who can help. While it’s best to speak up right away, as soon as you feel there is a problem - any of the below organizations can be contacted at any time - while you’re in the hospital, or after you have been discharged.
Hospitals in Massachusetts want to hear about their quality of services. The names of departments which handle complaints have different names, such as: patient relations, customer service, patient advocacy, etc. These departments exist to assist you with concerns you have about your care. These staff listen to your problems and help you decide what action to take. Get more details on your options at the hospital level here.
If your attempt to resolve the problem with your practitioner or hospital does not lead to a satisfactory resolution, then consider sending your complaint to an external organization that addresses health care quality. Below are organizations that help you prepare and follow through with health care quality complaints. Each organization has a different mission, so look for the one(s) that will be most helpful to you.
Filing a complaint against a hospital or other health care facility (not an individual clinician)
The Department of Public Health, Division of Health Care Quality (DHCQ)
Department of Public Health | 99 Chauncy St. | Boston, MA 02111
The Division of Health Care Quality (DHCQ) is the state government agency that licenses health facilities in Massachusetts. It also investigates complaints against a facility. Facilities include hospitals, nursing homes, rest homes, chronic renal dialysis units, home health agencies, hospices, ambulatory surgical centers, clinical laboratories, blood banks, clinics, rehabilitative services and state schools. DHCQ investigates all complaints of patient abuse and neglect in long-term care facilities, including nursing homes and assisted living residences. DHCQ does not handle complaints against individual clinicians.
Advice about what to do AND help talking to your hospital:
Betsy Lehman Center for Patient Safety and Medical Error Reduction
Department of Public Health | 99 Chauncy Street | Boston, MA 02111
Ombudsman Phone: 617-753-7308
The Lehman Center has staff available to offer consumers guidance on how to address some of their patient safety and quality of health care concerns and issues (including how to make a formal complaint about a hospital or health care provider). The Center is named for Betsy Lehman, a Boston Globe reporter, who died in 1994 from a chemotherapy overdose. This Center also works to improve health care quality by spreading the word on practices that increase patient safety and reduce medical errors.
Advice about what to do AND support groups with others impacted by a poor medical experience:
Medically Induced Trauma Support Services (MITSS)
830 Boylston St, Suite 206 | Chestnut Hill, MA 02467
Phone: 1-888-36MITSS (1-888-366-4877)
MITSS is available to help you or a family member that experienced stress from poor medical care. This organization has confidential telephone support, offers encouragement and support, and resources and information. Along with helping patients harmed in the delivery of health care, MITSS also works with clinicians that were involved in a poor care situation. This website has a section for patients and families. Posted are stories of others and how they dealt with the emotional impact of the poor care.
Help when the person harmed used Medicare to pay (health insurance for older people and those with disabilities):
245 Winter Street | Waltham, MA 02451-1231
Phone Helpline: 800-252-5533
MassPro advises Medicare beneficiaries about the rights and protections they have under the federal Medicare program. One right is the right to quality health care. This right means Medicare beneficiaries should receive care in a timely way, should receive care that was ordered, and should not be given the wrong medication or wrong dose of medication.
MassPro has a telephone helpline and a complaint and mediation program. Mediation can sometimes help with situations of poor communication or misunderstandings between the patient and health care provider. Mediation brings together both parties for a face to face meeting with an impartial and trained mediator. MassPro will help you write up your complaint. All services are free and voluntary. You can file a complaint and get help finding other resources. You can also file a complaint and remain anonymous (not identified).
To file a complaint against a health care worker (doctor, nurse, social worker, etc.)
Massachusetts Board of Registration in Medicine
560 Harrison Avenue, Suite G-4 | Boston, MA 02118
Phone Hotline: 800-377-0550
This Board licenses and investigates complaints against physicians and acupuncturists. When it receives a complaint the Board reviews it, holds a hearing, and determines if care was delivered according to professional standards. If the Board decides the physician was not practicing according to professional standards, then the Board decides on the professional punishment. You can download a complaint form from the Board’s website or call on the phone and they will mail one to you. For more information on the Board’s complaint process, go to the Board’s website: http://www.massmedboard.org/consumer/complaint.shtm.
This Board licenses nurses and investigates complaints. Complaints that a nurse violated standards of professional conduct include, negligence, practice beyond the scope of licensure, failure to adhere to acceptable standards of practice, fraud, practice while impaired by alcohol or drugs, sexual misconduct, fraudulent procurement of a license, and practice while license is lapsed. The boards do not handle disputes over fees. For more information on the complaint process, click here.
Massachusetts Division of Professional Licensure Boards
Other professional licensure boards have similar complaint processes. For information about clinicians other than doctors and nurses, please check the Division of Professional Licensure website.
Other health care practitioners include social workers, chiropractors, occupational therapists, physical therapists, psychologists, nutritionists, massage therapists, and many more. The complaint form for all these health care workers is found at this link: http://www.mass.gov/Eoca/docs/dpl/complaint.pdf
To file a complaint about the quality of care at a facility accredited by the Joint Commission on Health:
Joint Commission on Health
The Joint Commission | One Renaissance Boulevard | Oakbrook Terrace, IL 60181
This organization visits and certifies that health care organizations and programs meet certain standards. Hospitals and nursing homes are likely to be Joint Commission accredited, but other programs may be also, such as a hospice program or a rehabilitation facility. The Joint Commission will investigate some kinds of complaints about institutions they have accredited. Please visit their website for details and instructions about the complaint process.
Help getting health insurance:
Health Law Advocates
30 Winter St., Suite 940 | Boston, MA 02108
Health Law Advocates helps income-eligible people resolve insurance-related problems, for example:
- denial of coverage due to a preexisting condition,
- denial of medically necessary health care,
- loss of insurance following a divorce.
The Commonwealth Connector
Phone: 1-877-MA-ENROLL (1-877-623-6765)
This is a free call.
This new state agency helps Massachusetts residents find health insurance that is affordable and meets the requirements of our new state law.
To get legal advice and representation by an attorney:
Many people think that contacting a lawyer first is the best way to get the attention of a clinician or a facility and to resolve an unfortunate medical experience. While legal representation does help some people, it also has the effect of making people take sides and not talk to one another openly. This may delay emotional healing and coping with the new situation. Lawsuits take a lot of time and money. It may be years before a case is settled or decided by a court. Below appear a set of suggestions on what to consider when you are deciding whether to hire an attorney.
Tips and Advice from a Malpractice Attorney
The Patient Health Quality Council is not a legal advice organization and the information below is not legal advice. For some people, filing a lawsuit is important. They may have tried everything else and have not felt their side has been fairly heard. Below are suggestions on how to prepare a case and the steps involved in a lawsuits.
- Contact the health care practitioner or office and ask to set up an appointment to meet and discuss your care.
Tell the receptionist that you “have a few questions” about your care. Be polite. Act like you are seeking help. Try not to get into the conversation on the telephone regarding the care provided. Offer to compensate/pay the provider for his/her time. If the health care provider will not set up an in-person appointment, request a telephone conference call for a specific time.
If you are successful in setting up an appointment or conference call, have your questions well thought out. Write them down in advance. Ask another family member or friend to attend the appointment or be on the conference call with you. The family member/friend is there to listen and to help you make sense of what was said later. If you are going into the office to meet the health care provider let them know you are bringing a family member to “help you understand.”
Know how much time you are being given for the meeting or call and make sure you ask the most important questions first. When you are at the meeting or on the phone call, look at your questions and make sure you have had your most important questions answered. Do not bring up all the small issues and/or problems with other health care providers.
- If your physician will not speak to you (which is common) and the care was rendered in a hospital, contact the hospital.
Call the hospital’s patient advocate and ask for a meeting at the hospital. Ask for the meeting because you have questions about your care. Be polite when asking for the meeting. If you are successful in getting a meeting, let the hospital’s representative know you are bringing a family member to “help you understand.” Find out the name and positions of people that will be at the meeting.
You may need to write a letter outlining your concerns. If you intend to file a legal action be thoughtful in what you commit to writing.
Be polite at the meeting. Do not use this time to make a scene about how you have been wronged. Before leaving the appointment look at your questions and take a few minutes to make sure you have had your questions answered.
- If you are not successful in speaking with your health care provider and/or the hospital you can call the Board of Registration in Medicine, or visit the Board’s website to file a complaint.
If you were harmed by a physician you can fill out a complaint. The Board will investigate the incident and determine if it is within the Board’s jurisdiction. If the claim is judged to be within the jurisdiction of the Board it will contact the health care provider. A physician statement may be taken. The physician will “give evidence” about the occurrence. You will be able to access that information. The Web site contains information regarding how to file a complaint and how to assess information about health care providers.
- If the above steps are not helpful and you still want to sue, below are the steps to making a case:
- Get a full copy of your medical records to enable an attorney to investigate your claim. You cannot be denied a copy of your medical records because of an outstanding bill or money owed. However, you can be charged for the copying and for the time it took a staff person to copy the record.
- Make an appointment to meet with an attorney that specializes in health care malpractice cases. Malpractice means bad practice. If you want to consult with someone about finding a lawyer for your case, the Massachusetts Bar Association has a lawyer referral service.
Massachusetts Bar Association phone number: 866-627-7577 (free in Massachusetts). The local phone number in Boston is 617-654-0400. TTY for hearing impaired clients: 617-338-0585. Website: http://www.massbar.org/for-the-public/need-a-lawyer
- Know that you will have to prove that substantial harm was caused by the conduct of the health care provider. This causally related harm known as “damages” will have to be outlined by an expert (a physician) in a written report. Your attorney will assist you in obtaining this report. Once the case is supported by an expert suit will be filed.
- You will become the Plaintiff in a lawsuit and the health care provider will become the Defendant. The litigation process (the lawsuit) will take several years from the time of filing the Complaint until completion.
- To prepare for court both sides will send the other written questions to answer. This process is called “discovery” because each side discovers what evidence the other has to support their position. Both sides will also ask the other party verbal questions under oath; these questions and answers will be recorded by a stenographer. This process is known as a deposition.
- After discovery is completed, you and your attorney may decide to settle the case (both the Plaintiff and Defendant agree end the lawsuit with certain conditions). You need to know what you want from the lawsuit. Do you want monetary compensation for his/her harm or to help care for the injured person in the future? Do you want an explanation of what problems occurred in the delivery of care? Do you want an apology? Do you want stricter practices in the hospital so that this doesn’t happen to others? Do you want the health care practitioners fined or punished?
- If you do not settle the case before trial, then the case will proceed to trial. Should the case proceed to trial the trial can last several weeks.