Complaints About Physiotherapy Services - Patient Rights

Mrs Ewa paid for a package of ten treatments, and after four of them decided that "nothing was helping", demanding a full refund. Paweł, the practice owner, panicked - he didn't know whether he had to refund her, how to document it, or whether she could take the matter to a consumer ombudsman. Instead of following a calm procedure, he gave in to the pressure and refunded the entire amount, even though part of the treatments had been carried out correctly.

Complaints at a physiotherapy practice are a topic many owners are afraid of, because they mix consumer law with patient rights and the specific nature of a health service. In this article we explain what rights a patient has, when a complaint is justified, how to handle it, and how to protect yourself with documentation.

Patient or consumer - a double status

A person using private physiotherapy has two overlapping statuses:

• Patient - protected by the Act of 6 November 2008 on Patient Rights and the Patient Rights Ombudsman (the right to services consistent with current medical knowledge, the right to information, the right to medical records)
• Consumer - using a paid service, so protected by the Civil Code and the Act on Consumer Rights

This distinction is key. A complaint about the quality of a service is mainly a consumer-law matter, whereas a breach of patient rights or a professional error falls under professional and civil liability.

A physiotherapy service is an obligation of diligent effort

The most important legal principle: physiotherapy is an obligation of diligent effort, not an obligation of result. This means the therapist commits to performing the service in line with current knowledge and with due diligence, but does not guarantee a cure.

That's why simply "it didn't help" is not grounds for a refund if the treatments were carried out correctly. The grounds for a complaint are instead defective performance of the service - for example, a treatment inconsistent with the agreed plan, negligence, or causing harm.

When is a complaint justified?

A complaint about a physiotherapy service may be justified when:

• the treatment was carried out contrary to accepted professional standards or without due diligence
• the therapist failed to inform the patient of significant contraindications
• harm to health occurred through the therapist's fault
• the service was not performed despite payment being collected
• the therapist departed from the agreed plan without consent or information

A complaint is usually not justified when a patient simply did not achieve the expected result despite properly conducted therapy, or did not follow the recommendations given.

Patient rights worth remembering

The Act on Patient Rights grants patients, among others:

• the right to services consistent with current medical knowledge
• the right to information about their health and treatment plan
• the right to give or refuse consent to a treatment
• the right to medical records
• the right to lodge an objection or complaint

A patient can report a breach of these rights to the Patient Rights Ombudsman, and, in the case of a professional error, to the KIF (National Chamber of Physiotherapists, Poland's professional self-governing body for physiotherapists) - professional liability.

Step-by-step complaint-handling procedure

It's worth having an internal complaint procedure. A model process:

1. Receiving the complaint - ideally in writing (a form, an email), with the date received recorded
2. Registration - an entry in the complaints register
3. Analysis - comparing the allegation with the medical records and treatment plan
4. Contact with the patient - explanation, conversation
5. Decision - upholding, partially upholding, or rejecting the complaint with reasons
6. Written response - within a reasonable time
7. Resolution - refund, correction, or additional treatment, if the complaint is justified

Response deadlines

In consumer relations, the rule is that a failure to respond to a complaint within the statutory deadline may be treated as accepting it. So it's good practice to respond to complaints within 14 days, and always in writing or on a durable medium. Never leave a complaint unanswered - that is the most common mistake, and it works against the practice.

Stage	Recommended deadline
Confirmation of receipt of the complaint	immediately
Review and response	within 14 days
Resolution of an upheld complaint	as agreed

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How does documentation protect your practice?

The best defence against an unjustified complaint is reliable medical records. If a patient's file contains:

• a description of the patient's initial condition and the goal of the therapy
• signed consent for the treatments
• a description of each treatment and the patient's reaction
• a record of the recommendations given

then you can demonstrate that you acted in line with accepted standards. Without documentation, you're in a weaker position - a "your word against mine" situation usually goes against the practice.

Refunds for unused treatments from a package

A common dispute concerns packages. If a patient withdraws partway through, the rule is simple: payment is owed for treatments carried out, and, as a rule, a refund is owed for treatments not carried out, unless the terms and conditions provide for other lawful arrangements (e.g. a package price lower than the sum of individual treatments). You cannot, however, apply terms that grossly infringe consumer interests (unfair contract terms), as these are unenforceable.

Complaints versus professional liability

It's worth distinguishing an ordinary service-quality complaint from an allegation of a professional error. If a patient claims the therapist acted contrary to accepted professional standards and caused harm to their health, the matter may go before the disciplinary ombudsman and court of the KIF, as well as to civil proceedings. At that point, the therapist's mandatory professional liability insurance comes into play. That's why you should treat every serious complaint seriously, document how the case was handled, and, if in doubt, consult your insurer before admitting fault or offering compensation.

Most common mistakes when handling complaints

• no response at all to the complaint (the most dangerous mistake)
• giving in to pressure and refunding the full amount despite treatments having been carried out correctly
• no procedure or complaints register
• admitting fault without analysing the documentation
• failing to document the decision and its reasoning

Frequently asked questions

Do I have to refund the money if the therapy didn't produce results?

No, if the treatments were carried out correctly and in line with accepted knowledge. Physiotherapy is an obligation of diligent effort, not a guarantee of results. A refund is owed when the service was performed defectively or not performed at all. Documentation showing that you acted correctly is key.

Where can a patient complain if I reject their complaint?

The patient can turn to the Patient Rights Ombudsman, the municipal or district consumer ombudsman, and, in the case of an allegation of a professional error, to the KIF. They can also pursue claims through civil proceedings. That's why it pays to handle complaints diligently and document every decision.

Do I have to accept complaints only in writing?

You don't have to require the written form exclusively, but it's worth encouraging complaints in writing or by email, as this makes it easier to document the case. A verbal complaint should also be recorded. What matters most is that every complaint is logged and dealt with within the deadline.

Does a patient have the right to a refund for unused treatments from a package?

As a rule, yes - a refund is owed for treatments not carried out. You can set out the rules for settling a package in your terms and conditions, provided they don't grossly infringe consumer interests. Terms such as "no refund whatsoever" tend to be treated as unlawful, so draft your terms and conditions carefully.

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Related articles:
- KIF inspection at a physiotherapy practice
- How to correctly keep a patient's file in physiotherapy
- Medical records in physiotherapy