Holly M Tibble1, Nigel S Broughton2,3, David M Studdert4,5, Matthew J Spittal1, Nicola Hill6, Jennifer M Morris1, Marie M Bismark1. 1. Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. 2. Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia. 3. Orthopaedic Division, Peninsula Health, Melbourne, Victoria, Australia. 4. Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California, USA. 5. Stanford Law School, Stanford University, Stanford, California, USA. 6. Department of Otolaryngology, Nelson Marlborough District Health Board, Nelson, New Zealand.
Abstract
BACKGROUND: Compared with other doctors, surgeons are at an increased risk of medicolegal events, including patient complaints and negligence claims. This retrospective study aimed to describe the frequency and nature of complaints involving surgeons compared with physicians. METHODS: We assembled a national data set of complaints about surgeons and physicians lodged with medical regulators in Australia from 2011 to 2016. We classified the complaints into 19 issues across four domains: treatment and procedures, other performance, professional conduct and health. We assessed differences in complaint risk using incidence rate ratios (IRRs). Finally, we used a multivariate model to identify predictors of complaints among surgeons. RESULTS: The rate of complaints was 2.3 times higher for surgeons than physicians (112 compared with 48 complaints per 1000 practice years, P < 0.001). Two-fifths (41%) of the higher rate of complaints among surgeons was attributable to issues other than treatments and procedures, including fees (IRR = 2.68), substance use (IRR = 2.10), communication (IRR = 1.98) and interpersonal behaviour (IRR = 1.92). Male surgeons were at a higher risk of complaints, as were specialists in orthopaedics, plastic surgery and neurosurgery. DISCUSSION: Surgeons are more than twice as likely to attract complaints as their physician peers. This elevated risk arises partly from involvement in surgical procedures and treatments, but also reflects wider concerns about interpersonal skills, professional ethics and substance use. Improved understanding of these patterns may assist efforts to reduce harm and support safe practise.
BACKGROUND: Compared with other doctors, surgeons are at an increased risk of medicolegal events, including patient complaints and negligence claims. This retrospective study aimed to describe the frequency and nature of complaints involving surgeons compared with physicians. METHODS: We assembled a national data set of complaints about surgeons and physicians lodged with medical regulators in Australia from 2011 to 2016. We classified the complaints into 19 issues across four domains: treatment and procedures, other performance, professional conduct and health. We assessed differences in complaint risk using incidence rate ratios (IRRs). Finally, we used a multivariate model to identify predictors of complaints among surgeons. RESULTS: The rate of complaints was 2.3 times higher for surgeons than physicians (112 compared with 48 complaints per 1000 practice years, P < 0.001). Two-fifths (41%) of the higher rate of complaints among surgeons was attributable to issues other than treatments and procedures, including fees (IRR = 2.68), substance use (IRR = 2.10), communication (IRR = 1.98) and interpersonal behaviour (IRR = 1.92). Male surgeons were at a higher risk of complaints, as were specialists in orthopaedics, plastic surgery and neurosurgery. DISCUSSION: Surgeons are more than twice as likely to attract complaints as their physician peers. This elevated risk arises partly from involvement in surgical procedures and treatments, but also reflects wider concerns about interpersonal skills, professional ethics and substance use. Improved understanding of these patterns may assist efforts to reduce harm and support safe practise.
Authors: Jackie van Dael; Tom W Reader; Alex Gillespie; Ana Luisa Neves; Ara Darzi; Erik K Mayer Journal: BMJ Qual Saf Date: 2020-02-04 Impact factor: 7.035
Authors: Pieter F van den Berg; Derya Yakar; Andor W J M Glaudemans; Rudi A J O Dierckx; Thomas C Kwee Journal: Eur Radiol Date: 2019-03-22 Impact factor: 5.315