Volume 195 - Issue 6
Prevalence and characteristics of complaint-prone doctors in private practice in Victoria
Author: John A Buntine
Med J Aust 2011; 195 (6): 325. || doi: 10.5694/mja11.10874
Published online: 19 September 2011
Published online: 19 September 2011
To the Editor: Bismark, Spittal and Studdert observed that complaints clustered around certain doctors.1 They state that, in Victoria, extrapolations from their findings indicate that 1% of the medical workforce in private practice accounts for nearly 20% of complaints, and that male surgeons who have practised for more than 30 years are the doctors who are most complained about.1
Bismark and colleagues established that complaint-prone doctors are more likely to be male, surgeons or psychiatrists, to have trained in Australia and to have been in practice for at least 30 years. They agree with previous studies that suggest that the inherent risks of surgical procedures and the relative visibility of poor surgical outcomes are likely to play a role, and also note that the potential for power imbalances between doctor and patient is high in both surgery and psychiatry.
That training outside of Australia was found to have a “protective effect” may seem surprising, but this fits my view about what most often motivates a patient to complain about a doctor when something goes a little astray.
My belief, based on a long period of surgical practice and of observing other doctors, largely surgeons, is that a common stimulus to make a complaint when there is a degree of dissatisfaction is a perception that the doctor was overconfident, perhaps to the point of arrogance, and had little personal interest in the patient’s welfare. The lower self-confidence of some overseas-trained surgeons could therefore lessen the likelihood of complaints being made about them, whereas the supreme confidence of some highly experienced Australian-trained surgeons may go against them when something goes wrong.
Good manners, kindness, demonstrations of personal interest and concern, and a degree of humility all discourage complaints!
In an article subtitled “Arrogance: the biggest sin of all”,2 in the United Kingdom Telegraph, in 2009, Dr James LeFanu appropriately commented, “The virtues of generosity, cheerfulness and discretion should be the hallmark not just of medicine, but of all the liberal professions. How many doctors live up to these ideals is, of course, impossible to quantify, but certainly some readers of this column take a rather jaundiced view”.2
Competing interests
No relevant disclosures.
References
- Bismark MM, Spittal MJ, Studdert DM. Prevalence and characteristics of complaint-prone doctors in private practice in Victoria. Med J Aust 2011; 195: 25-28.
- LeFanu J. Dr James LeFanu: arrogant doctors. The Telegraph (UK) 2009; 1 Jul. http://www. telegraph.co.uk/health/healthadvice/james lefanu/5696975/Dr-James-LeFanu-arrogant-doctors.html (accessed Aug 2011).