State of the Science on Risk and Support Factors to Physician Performance: A Report from the Pan-Canadian Physician Factors Collaboration

Yen, Wendy; Thakkar, Niels

doi:10.30770/2572-1852-105.1.6

Cited by 8 publications

(13 citation statements)

References 5 publications

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“…Increased workload was associated with increased complaints, medical errors and poor assessment performance. 43 50 One study did not find a relationship between complaints and clinical load. 39 …”

Section: Resultsmentioning

confidence: 98%

“… 30 41 44 A higher proportion of doctors with impaired performance had mental health issues including bipolar disorder, depression and anxiety 23 27 37 and problems with mental health increased with age. 43 Doctors and their peers were often aware of the presence of an underlying issue with one-third of doctors self-referring for cognitive assessment. 23 Higher levels of burn-out (eg, depersonalisation) related impaired performance was reported by three of four studies 30 41 44 and associated with more hours of direct patient care, more hours on-call and more shifts per month.…”

Section: Resultsmentioning

confidence: 99%

“…Cognitive performance is affected by age 43 and deteriorates throughout the course of successive shifts, being significantly worse in the fifth and sixth shift, and/or longer shift length. 49 Doctors presented to PHPs with four principal reasons for impaired performance: (1) brain disease (48%); (2) mood/anxiety disorders or treatment side effects (28%); (3) substance use (9%) and (4) traumatic brain injury (7%).…”

Section: Resultsmentioning

confidence: 99%

“…There was a 3.6 times greater risk of complaints during patient monitoring and follow-up, 32 however, a 2019 Canadian report found that the majority of complaints were related to the clinical aspects of care, rather than issues with communication and/or unethical or improper behaviour. 43 …”

Section: Resultsmentioning

confidence: 99%

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Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Austin

Nullwala

et al. 2021

BMJ Open

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ObjectiveTo identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners.DesignSystematic review.Data sourcesOvid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsearched.ResultsSixty-seven peer-reviewed papers and three grey literature publications from 2011 to March 2020 were reviewed by pairs of independent reviewers. Twenty-three key factors identified, which were categorised as demographic or workplace related. Gender, age, years spent in practice and greater number of patient lists were associated with higher risk of malpractice claim or complaint. Risk factors associated with physician impaired performance included substance abuse and burn-out.ConclusionsIt is likely that risk factors are interdependent with no single factor as a strong predictor of a doctor’s risk to the public. Risk factors for malpractice claim or complaint are likely to be country specific due to differences in governance structures, processes and funding. Risk factors for impaired performance are likely to be specialty specific due to differences in work culture and access to substances. New ways of supporting doctors might be developed, using risk factor data to reduce adverse events and patient harm.PROSPERO registration numberPROSPERO registration number: CRD42020182045.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Austin

Nullwala

et al. 2021

BMJ Open

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“…Though training; specialty or type of practice; and gender; as such outcomes have been detailed as potential factors relating to physician performance. [17][18] Ethics approval was obtained from the University of Alberta's Health Research Ethics Board -Health Panel (Study ID: Pro00079279).…”

Section: The Mccqe Part I and Part Iimentioning

confidence: 99%

Does Pass/Fail on Medical Licensing Exams Predict Future Physician Performance in Practice? A Longitudinal Cohort Study of Alberta Physicians

Champlain¹,

Ashworth²,

Kain³

et al. 2020

Journal of Medical Regulation

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The purpose of this longitudinal study was to gather extrapolation evidence of validity by assessing whether performance on a national medical licensing exam, in addition to practice and socio-demographic variables, is predictive of future physician performance in practice. The study focused on a cohort of 3,404 physicians who were registered with the College of Physicians and Surgeons of Alberta (CPSA) and who completed the Medical Council of Canada Qualifying Examination (MCCQE) Parts I and II between 1992–2017. Separate multivariate quasi-Poisson regression models were run to assess the degree of relationship between first-time pass/fail status on the MCCQE I and II, and several CPSA socio-demographic variables and several CPSA socio-demographic variables, in addition to complaints/physician and various prescribing flags. Candidates who failed the MCCQE I on their first attempt had 27% more complaints lodged against them, compared to those who passed. Physicians who failed the MCCQE II on their first attempt prescribed 2+ benzodiazepines and 2+ opioids to 30% more patients than those who passed. Conclusions: Performance on the MCCQE Part I and II is an important predictor of physician performance. Combined with other critical variables, these measures provide important evidence to aid in risk modeling efforts and to guide educational interventions for physicians at an early stage of their careers.

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Should we screen aging physicians for cognitive decline?

Shilnikova,

Momoli,

Taher

et al. 2023

Aging & Mental Health

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State of the Science on Risk and Support Factors to Physician Performance: A Report from the Pan-Canadian Physician Factors Collaboration

Abstract: This report has been made available for readers of the Journal of Medical Regulation courtesy of the Pan-Canadian Physician Factors Collaboration. Copyright and all rights reserved by the Pan-Canadian Physician Factors Collaboration.

Cited by 8 publications

References 5 publications

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

Does Pass/Fail on Medical Licensing Exams Predict Future Physician Performance in Practice? A Longitudinal Cohort Study of Alberta Physicians

Should we screen aging physicians for cognitive decline?

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