Volume 196 - Issue 1
Prevalence and characteristics of complaint-prone doctors in private practice in Victoria
Authors: Matt Vance, Michael Ward and David McKenzie
Med J Aust 2012; 196 (1): 38. || doi: 10.5694/mja11.10963
Published online: 16 January 2012
Published online: 16 January 2012
To the Editor: We noted with interest the recent publication by Bismark and colleagues1 about complaint-prone doctors in Victoria. This research makes a valuable contribution to the important task of identifying practitioners who are at high risk of delivering poor quality health care. Similar analysis of more than 32 000 complaints received in Queensland from 1992 to 2010 has been undertaken by the Health Quality and Complaints Commission (HQCC). A summary of this work, which was performed in collaboration with the Medical Board of Queensland, was presented recently.2
Between July 2006 and June 2010, only 5% of medical practitioners registered as practising in Queensland were the subject of a complaint in a given year. Medical practitioners with multiple complaints (four or more complaints over the period; 0.7% of all medical practitioners) have substantially more complaints (> 2 SD) than their peers (average number of complaints, 1.6).
An analysis of a subgroup of 117 doctors who were each the subject of multiple complaints revealed that they were more likely to be men, to have specialist rather than general registration, and to have an Australian rather than a non-Australian first qualification. Surgeons made up over 40% of this subgroup and were more likely to be the subject of a complaint than were other specialists. Further work is underway to clarify the level of complaints relative to the number of registered practitioners within each specialty.
Although there are differences in the samples and analytical methods used in the HQCC study compared with those used by Bismark et al, there are striking similarities in the central findings: a small proportion of doctors produce a disproportionate number of complaints, and past complaint history is predictive of future complaint risk.
Health complaints commissions in Australian states are working closely with the Australian Health Practitioner Regulation Agency to explore remedial or preventive opportunities. This task needs to involve the health care industry and professional colleges, as these complaint-prone practitioners are often well known by their colleagues or employers but, equally often, not adequately managed. As there is evidence that unprofessional medical student behaviour predicts both unprofessional doctor behaviour and risk of disciplinary activity,3-4 medical schools should also be engaged in this task.
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. 0_i1142863xxx
- Ward M, Pulsford P, Johnstone P. The characteristics of doctors who generate multiple patient complaints to a regulatory agency. Proceedings of the 27th International Conference, International Society for Quality in Health Care; 2010 Oct 10-13; Paris, France. http://www.isqua. org/abstract-conference/paris-2010-quality-outcomes-achieving-patient-improvement/wednesday-13th-october-morning.htm%20C9 (accessed Nov 2011).
- Stern DT, Frohna AZ, Gruppen LD. The prediction of professional behaviour. Med Educ 2005; 39: 75-82. 0_i1142863
- Papadakis MA, Teherani A, Banach MA, et al. Disciplinary action by medical boards and prior behavior in medical school. N Engl J Med 2005; 353: 2673-2682. 0_i1142867