SURGEONS are almost nine times more likely than GPs in Victoria to be subject to multiple patient complaints, according to new research in the MJA.
The researchers used data from the Victorian Health Services Commissioner between 2000 and 2009 to identify complaint-prone doctors — defined as those with four or more complaints over the study period — in private practice. (1)
They found that a small group of doctors were responsible for almost 18% of complaints in the state.
“… extrapolations from our findings indicate that less than 100 practitioners, or 1% of the medical workforce in private practice, account for nearly 20% of complaints”, the researchers wrote.
Complaint-prone doctors were more likely to be surgeons, psychiatrists, male, have trained in Australia and to have been in practice for more than 30 years.
“… it is incorrect at the population level to construe doctors’ experiences with medicolegal matters as merely ‘luck of the draw’. Complaints clearly cluster around certain doctors”, the researchers wrote.
Compared with GPs, surgeons had nine-times the odds of being complaint-prone, while psychiatrists were 4.5 times more likely to be complaint-prone.
Dr John Quinn, executive director of surgical affairs with the Royal Australasian College of Surgeons, said the frequency of complaint-prone surgeons was likely due to the nature of surgical work, which involved a personal doctor-patient interaction, was often invasive and had obvious, measurable outcomes.
Dr Quinn said he was not concerned about the number of complaint-prone surgeons because the study did not examine the outcome of complaints.
“Just because you’re complained about doesn’t mean that it’s valid … It would be interesting to know whether the complaints that were investigated were justified”, he said.
Beth Wilson, Victoria’s Health Services Commissioner, said she wasn’t surprised that a small number of doctors accounted for a large proportion of complaints, but this was the first time she had seen hard evidence.
“It’s information that I think we need to take seriously. It’s a well researched and well documented study and the royal colleges really need to take this research on board”, she said.
Dr Quinn said that his college monitored complaints against surgeons and intervened as appropriate, in addition to providing counselling.
“Sometimes, if there have been a number of complaints against a particular surgeon, the college may mandate that they have to undertake anger management classes or communication skills classes to maintain their fellowship of the college”, he said.
Dr Quinn said the college also offered various continuing professional development courses, which may help doctors minimise complaints on topics such as communication skills, dealing with difficult patients and delivering bad news.
Avant, Australia’s largest medical defence organisation, said it provided specific risk management activities for doctors who had received a complaint or who had been subject to more complaints or claims than their colleagues.
Mark Williams, Avant’s general manager of retention and growth, said any doctor who had a risk profile distinctly different to the average member was reviewed.
“This does not necessarily mean a premium modification is made as there are other ways to amend insurance terms; eg, exclusions, deductibles, etc. Only about 0.25% of our members have a higher number of complaints or claims than their colleagues that in turn warrant either a combination of different levels of cover or terms”, Mr Williams said.
Ms Wilson said that although education and risk management activities were important, the new information raised questions of whether more action was needed to support complaint-prone doctors.
The research found that although particular doctors were complaint prone, the overall risk of receiving a complaint was low. About 80% of doctors in private practice in Victoria received no complaints during the study period.
“It’s actually a rare event for a doctor to be complained about, but alarm bells do go off if doctors are complained against a number of times”, Ms Wilson said.
– Sophie McNamara
Posted 4 July 2011
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