Where to Report Unprofessional Conduct by a Doctor (Philippine Context)

This guide explains where and how to report a Philippine-licensed physician for unprofessional conduct, what each office can (and cannot) do, and how to prepare a strong, safe complaint. It’s practical information, not legal advice.

Quick map — who handles what

Professional Regulation Commission (PRC) – Board of Medicine For: professional/ethical breaches by physicians; licensing discipline. Outcome: reprimand, fine, suspension, or revocation of license.
Hospital/Clinic (Patient Relations, Quality/Patient Safety, Medical Staff Office, Ethics Committee) For: incidents within a facility; bedside conduct; care quality; rude staff; unsafe processes. Outcome: corrective actions, apologies, billing fixes, internal sanctions; may escalate to PRC.
Philippine Medical Association (PMA) & Specialty Societies For: violations of the medical Code of Ethics; peer review/mediation. Outcome: admonition, suspension/expulsion from the association; can recommend PRC action.
Department of Health (DOH) — Health Facility and Services Regulatory units & regional Centers for Health Development (CHDs) For: complaints about a facility (licensing, staffing, equipment, infection control, overcapacity, noncompliance). Outcome: fines, suspension, or closure orders against facilities (not a doctor’s PRC license).
PhilHealth For: fraudulent claims, “upcasing,” ghost patients, forced admissions tied to benefits. Outcome: suspension/termination of accreditation of the doctor/facility; restitution.
National Privacy Commission (NPC) For: privacy breaches—improper disclosure of your medical information, loss/leak of records. Outcome: compliance orders, penalties, data-handling corrective measures.
Police/NBI → Prosecutor’s Office For: crimes (e.g., sexual misconduct, extortion, falsification of medical certificates, physical injuries through reckless imprudence). Outcome: criminal prosecution and penalties.
Office of the Ombudsman / Civil Service Commission (CSC) For: administrative offenses by government-employed doctors (DOH/LGU/public hospitals). Outcome: suspension, dismissal, forfeiture of benefits; separate from PRC licensing.
Insurance Commission For: HMO/health-insurer claim denials, unfair practices (billing/coverage disputes). Outcome: insurer/HMO corrective orders; not discipline of the medical license.
Commission on Human Rights (CHR) For: rights-based issues (discrimination, inhumane treatment, violations against vulnerable groups). Outcome: investigations, recommendations, coordination with prosecutors/DOH/PRC.

What counts as “unprofessional conduct”?

Common examples (non-exhaustive):

Quality/safety: gross negligence, incompetence, abandonment of patient, practicing while impaired.
Ethics/behavior: sexual advances, harassment, discrimination, rudeness coupled with refusal of necessary care, breach of informed consent.
Integrity: falsifying records or medical certificates, kickbacks, improper advertising, fee-splitting.
Privacy: unauthorized disclosure of health information, mishandling records.
Compliance: practicing without valid license/accreditation, outside of declared specialty, dispensing prohibited drugs, ignoring mandatory reporting (e.g., notifiable diseases).

Important: Some acts are both professional misconduct and crimes. You can file in multiple venues (e.g., PRC + police) at the same time.

Choosing the right venue (simple decision guide)

You want the doctor’s license investigated/penalized → PRC Board of Medicine.
The issue happened in (or because of) a hospital/clinic → Facility grievance (Patient Relations/Quality) first; consider DOH if it’s a facility compliance problem; still file with PRC for the doctor’s conduct.
It’s mainly a billing/insurance dispute → Insurance Commission (and PhilHealth if PhilHealth is involved).
Your health data was leaked or misused → National Privacy Commission; notify the facility too.
It’s a government doctor → Ombudsman/CSC for admin case + PRC for license.
There’s sexual misconduct, threats, fraud, or physical harm → PNP/NBI → Prosecutor immediately, plus PRC.
You prefer peer mediation or a professional ethics forum → PMA or the relevant specialty society (e.g., surgeons, pediatricians).

How to prepare before you report

Write a concise timeline (dates, times, names, what was said/done).
Gather evidence
- doctor’s name, clinic/hospital, receipts, prescriptions, orders;
- medical records (you’re entitled to copies as the patient or next-of-kin/authorized representative);
- photos/videos, messages, call logs;
- witness statements (sworn if possible);
- any billing/insurance correspondence.
Get a medico-legal when appropriate (injuries, sexual misconduct).
Secure privacy — redact sensitive data of third parties; share only what’s needed.
Consider legal advice for serious injury, death, or high-stakes claims (civil damages or criminal liability).

Filing with key bodies — what to expect

1) PRC – Board of Medicine

Jurisdiction: All Philippine-licensed physicians.
Grounds: Unprofessional conduct, gross negligence/incompetence, immoral conduct, violations of the Medical Act/PRC rules/Code of Ethics.
How to file:
- Prepare a verified (notarized) complaint-affidavit stating facts, grounds, and relief sought.
- Attach IDs, proof of authority (if filing for a minor/deceased), evidence and witness affidavits.
- File at PRC Central or any PRC Regional Office (addressed to the Board of Medicine).
- Pay any required filing fee (keep the OR).
Process (typical): docketing → answer → preliminary conference → hearing(s) → decision.
Possible penalties: reprimand, fine, suspension, or revocation of license.
Appeal: to the PRC Commission and then to the Court of Appeals (Rule 43).

2) Hospital/Clinic grievance channels

Where to go: Patient Relations/Customer Care, Quality/Patient Safety, attending physician’s Department Chair, Medical Staff Office (for physician privileges), and Ethics Committee.
What they can do: immediate corrections (re-assignment of doctor, second opinion, record fixes), Root Cause Analysis, apologies, billing adjustments, and sanctions (warning, suspension of admitting/surgical privileges).
Tip: Ask for a written acknowledgment and case/incident number; request the Resolution Letter.

3) PMA & Specialty Societies

Nature: Professional association (membership-based).
Usefulness: Peer review, mediation, ethics decisions; can forward/coordinate with PRC.
Limitations: They cannot revoke a PRC license; sanctions mainly affect membership/standing.

4) DOH (Facility regulation)

Scope: Licensing compliance of hospitals/clinics, staffing standards, infection control, unsafe premises, refusal of emergency care, etc.
Where to file: DOH central regulatory units or regional CHDs.
Outcomes: orders vs. the facility (fines, suspension, closure), and referrals to PRC/other bodies if provider-specific.

5) PhilHealth

When to file: suspected false claims, “upcasing,” unnecessary admissions for benefit maximization, balance billing violations in mandated cases.
Outcomes: suspension/revocation of accreditation for doctors/facilities, recoveries, administrative penalties.
Note: Accreditation discipline is separate from the PRC license.

6) National Privacy Commission (NPC)

When: your medical data was disclosed/used without authority, lost, or accessed by unauthorized persons.
What to submit: incident narrative, proof of identity, supporting documents (screenshots, letters), proof you first raised it with the clinic/hospital (if feasible).
Outcomes: compliance orders, penalties, and mandated corrective actions.

7) Police/NBI & Prosecutor (Criminal cases)

Examples: sexual assault/harassment, extortion, falsification of medical records/certificates, physical injuries via reckless imprudence, illegal drug prescribing/dispensing.
Steps: blotter/complaint; medico-legal (if needed); sworn statements; filing with the Prosecutor’s Office for inquest/preliminary investigation.

8) Ombudsman / CSC (Government doctors)

Who: DOH/LGU hospital doctors, barangay/municipal/city/provincial health officers, other public posts.
Acts: grave misconduct, oppression, neglect of duty, dishonesty, etc.
Outcomes: suspension, dismissal, forfeiture of benefits; may refer to PRC or prosecutors.

9) Insurance Commission

Focus: HMO/insurer claims and unfair practices tied to medical services.
Outcome: orders to the insurer/HMO; may help resolve billing deadlocks with facilities.

10) Commission on Human Rights

Use when: discrimination (e.g., against persons with HIV, LGBTQIA+, PWDs), degrading treatment, or other human-rights concerns in care contexts.
Outcome: investigations, coordination and recommendations to enforcement and regulators.

Can you file in multiple places?

Yes. Parallel filings are common and strategically sensible:

Example: PRC (license) + Hospital (internal sanction) + Police/Prosecutor (crime) + NPC (privacy) + PhilHealth (fraud). These processes are independent. A settlement with a hospital typically does not bar PRC or criminal cases.

Civil lawsuit vs. “reporting”

Civil case for damages (malpractice) is separate. You file a complaint in court against the doctor and/or hospital.
You’ll usually need expert medical testimony to prove the standard of care, breach, causation, and damages.
Time limits (prescription) exist and can be complex (contract vs. tort). Consult counsel early.

Practical safeguards (defamation, retaliation, privacy)

Stick to facts; avoid speculation. Truthful and documented complaints are your best protection.
Qualified privilege: Statements in official complaints to authorities are generally protected—do not publish them on social media.
Ask for confidentiality where available (especially for sexual misconduct or minors).
Redact identifiers of third parties in submissions (unless essential).
Safety first: If you fear retaliation or threats, coordinate with authorities and trusted relatives.

Template: Complaint–Affidavit (you can adapt this)

COMPLAINT–AFFIDAVIT

I, [Full Name], Filipino, of legal age, [civil status], and residing at [address], after being duly sworn, state:

1. I am the patient / parent/guardian / authorized representative of [Patient Name, age].
2. Respondent is Dr. [Full Name], a physician practicing at [facility/clinic], with address at [if known].
3. On [date/time], at [place], the following occurred: [clear, chronological facts].
4. Because of these acts/omissions, I suffered: [injury/harm/expense/trauma], as shown by [documents].
5. Grounds: [unprofessional conduct / gross negligence / breach of patient privacy / etc.].
6. I request that appropriate administrative/disciplinary action be taken against Respondent.

Attached are:
A. My government ID; B. Patient authorization (if filing for another); 
C. Medical records (list); D. Photos/videos; E. Receipts; F. Witness affidavits; G. Other evidence.

I certify the truth of the foregoing statements.

[Signature over printed name]
[Date and place]

SUBSCRIBED AND SWORN before me this [date] at [city], affiant exhibiting [ID details].

File this format (with attachments) at the PRC Board of Medicine and, with minor edits, at hospital Patient Relations/Quality, PMA, NPC, PhilHealth, Ombudsman/CSC, or the Prosecutor (who may require their own forms).

Frequently asked questions

Can I stay anonymous? Some offices accept confidential tips, but formal discipline usually requires a named, sworn complainant so the respondent can answer.

Do I need a lawyer? Not for filing administrative complaints. Lawyers are strongly recommended for criminal cases and civil suits for damages.

Can I get my records? Yes. Patients or authorized representatives have a right to copies of their own records and billing. Bring valid IDs and proof of authority.

How long will this take? Expect months; complex cases can take longer. Administrative, criminal, and civil tracks move at different speeds.

Will filing with the hospital stop me from going to PRC or court? No. Internal grievance processes do not waive or bar your right to pursue PRC, criminal, or civil remedies.

Checklist (printable)

Timeline of events (with dates, names, quotes).
Copies of medical records and billing.
Evidence (photos, messages, recordings where lawful).
Witness names and contact details; sworn statements if possible.
Government ID; proof of authority (if filing for someone else).
Notarized complaint-affidavit.
Parallel filings planned (PRC / Hospital / PhilHealth / NPC / Police / Ombudsman/CSC).

Final notes

You can file in parallel to protect the public (PRC), fix facility problems (Hospital/DOH), recover or stop fraud (PhilHealth/Insurance Commission), protect your privacy (NPC), and seek accountability (Police/Prosecutor/Ombudsman/CSC).
Laws, rules, and forms evolve; for high-stakes matters, consult a lawyer or a legal aid clinic for tailored advice.