Education trajectories and malpractice complaints—A study among Danish general practitioners

Birkeland, Søren; Bogh, Søren Bie

doi:10.1080/2331186x.2018.1473747

Cited by 7 publications

(15 citation statements)

References 18 publications

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“…In this line, it should not be considered unexpected that the experience caused by increasing seniority may have the protective function against complaints as shown in this study. As other studies, increasing seniority has been shown to increase the incidence of complaints or medical errors [3,14,17,18]. The reason for our finding may thus be the Norwegian system requiring a post-educational program for working in a PCEU [13].…”

Section: Discussionsupporting

confidence: 67%

“…The factors that act protecting against complaints in this study, may be the patient’s perception of professional confidence in the dialogue in addition to acquired skills. To our knowledge this significant manifestation of structured continuing education has not been shown in this setting before [ 1 , 14 , 15 ]. The proportion of the GPs qualifying for this specialty, has been increasing the last years.…”

Section: Discussionmentioning

confidence: 88%

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Physician factors associated with increased risk for complaints in primary care emergency services: a case – control study

et al. 2020

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Background Patient safety incidents defined as any unintended or unexpected incident that could have or were judged to have led to patient harm, are reported as relatively common. In this study patient complaints have been used as an indicator to uncover the occurrence of patient safety incidents in primary care emergency units (PCEUs) in Norway. Methods Ten PCEUs in major cities and rural parts of Norway participated. These units cover one third of the Norwegian population. A case-control design was applied. The case was the physician that evoked a complaint. The controls were three randomly chosen physicians from the same PCEU as the physician having evoked the complaint. The following variables regarding the physicians were chosen: gender, citizenship at, and years after authorization as physician, and specialty in general practice. The magnitude of patient contact was defined as the workload at the PCEU. The physicians’ characteristics and workload were extracted from the medical records from the fourteen-day period prior to the consultation that elicited the complaint. The rest of the variables were then obtained from the Norwegian physician position register. Logistic regression was used to estimate odds ratio for complaints both unadjusted and adjusted for the independent variables. The data were analyzed using SPSS (Version25) and STATA. Results A total of 78 cases and 217 controls were included during 18 months (September 1st 2015 till March 1st 2017). The risk of evoking a complaint was significantly higher for physicians without specialty in general practice, and lower for those with medium low and medium high workload compared to physicians with no duty during the fourteen-day period prior to the index consultation. The limited strength of the study did not make it possible to assess any correlation between workload and the other variables (physician’s gender, seniority and citizenship at time of authorization). Conclusions Continuous medical training and achieving the specialty in general practice were decisively associated with a reduced risk for complaints in primary care emergency services. Future research should focus on elements promoting quality of care such as continuing education, duty rosters and other structural and organizational factors.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 88%

Physician factors associated with increased risk for complaints in primary care emergency services: a case – control study

et al. 2020

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“…Nevertheless, studies have shown that increasing seniority increases the incidence of medical errors (13,14). The reason for the lack of this effect in our study, may once again be the Norwegian system requiring a post-educational program for unrestricted working in a PCEU (16).…”

Section: Discussionmentioning

confidence: 52%

“…This has induced the hypotheses that communication skills and experience are important factors in minimizing medical errors in these situations. We presume that the perception of being understood, may differ related to the physician's gender and mother tongue (12)(13)(14). Increasing experience in terms of training and seniority as a practising physician, should reduce the occurrence of errors.…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Physician factors associated with medical errors in Norwegian primary care emergency services. Based on a case – control study with patient complaints as an outset.

Bratland¹

2020

Preprint

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Background Patient safety incidents are reported as relatively common. To unravel the reasons for these incidents in primary care emergency units (PCEU), patient complaints have been used as an outset. Methods We included the PCEUs in ten major cities and rural parts of Norway, covering one third of the population. In the initial part of our study a case-control design was used to evaluate factors related to complaints. The controls where a random sample of three physicians from the same PCEU and time-period as the physician having evoked a complaint. The inclusion period was 18 months (September 1st 2015 till March 1st 2017). The physician characteristics were: gender, seniority, citizenship at authorization and specialty in general practice. Workload was defined as the magnitude of patient contacts. The physician identities and workload were extracted from the medical records from the fourteen-day period prior to the consultation that elicited the complaint. The other variables were obtained from the Norwegian physician position register. In the present study a total of 77 physicians were included in the complaint group and 217 in the random sample group. The assessments of the medical records were divided in three groups: medical error, inconclusive and no medical error. Associations between these groups, physician characteristics and workload, were tested by chi-square, Fisher’s exact and t-tests separately for the complaint and randomized group. The data were analyzed using SPSS. Results In the complaint group 53.2% of the medical records were assessed as being erroneous. In the random sample group this percentage was 3.2. The proportion inconclusive assessments was similar in both groups (29.9 and 27.6%). In the complaint group the percentages for no-error and inconclusive for the female physicians were 30.8 and 15.4; and for the male physicians 9.8 and 27.3, p=0.027. Conclusions In the complaint group male physicians had the lowest percentage no-error, and the highest percentage of inconclusive medical record for assessing medical errors, compared to their female colleagues. The Norwegian regulations for working in a PCEU may have modulated the impact of the other variables. Future research should focus on the underlying elements for these findings.

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“…Nicole et al, in their study, showed that 88% of the errors in orthopaedic surgeries were due to procedural errors and negligence (69). Acting based on medical guidelines and protocols, holding a counselling session to answer the questions of patients before the surgery, eliminating the financial relationship between the physician and patient completely are measures that can help prevent patient complaints and medical malpractice (70)(71)(72).…”

mentioning

confidence: 99%

Medical malpractice in Iran: A systematic review

Raeissi

Mirghaed

Sepehrian

et al. 2019

Med. J. Islam. Republ. Iran

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Background: Medical malpractice represents a serious problem in the health system and is one of the risk factors for patient safety which damages the patient and increases costs for the patient and the health care provider. The importance of these complaints against physicians is that litigation may continue for a long time and become problematic for patients and physicians. The objective of this study was to investigate the complaints of medical malpractices which were referred to Iran Medical Council to provide solutions to reduce the complaints and improve service delivery. Methods: Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, and Iranian databases, such as MagIran, SID, and Irandoc, were searched from 01/01/1990 to 07/01/2018. Also, the grey literature (via Google Scholar) was searched. Studies written in English or in Persian were searched, and keywords used included malpractice, negligence, medical malpractice, physician impairment, Iran, and professional impairment. Results: Nearly 1455 complaints (36%) of the total number of 3977 complaints were proved to be medical malpractice, and physicians were acquitted in 2542 (64%) cases. Most complaints were from gynaecologists, accounting for 43% of all complaints, followed by orthopaedic specialists who ranked second with 21.4% of the total complaints. The most type of failure was due to lack of skill (30.4%), followed by negligence (29.2%). Imprudence or indiscretion (26.3%) and noncompliance with governmental requirements (14.1%) were also in the next ranks, respectively. Conclusion: Improving patient and physician relationships, observing medical ethics, increasing the scientific and technical skills of the medical staff, and following the guidelines and medical protocols will prevent medical malpractice. Therefore, health policymakers can reduce errors and failures by adopting continuing education on medical, ethical, and legal issues.

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Education trajectories and malpractice complaints—A study among Danish general practitioners

Cited by 7 publications

References 18 publications

Physician factors associated with increased risk for complaints in primary care emergency services: a case – control study

Physician factors associated with increased risk for complaints in primary care emergency services: a case – control study

WITHDRAWN: Physician factors associated with medical errors in Norwegian primary care emergency services. Based on a case – control study with patient complaints as an outset.

Medical malpractice in Iran: A systematic review

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