Unsolicited patient complaints among radiation, medical, and surgical oncologists

Abstract

BACKGROUND Unsolicited patient complaints (UPCs) about physician practices are nonrandomly associated with malpractice claims and clinical quality. The authors evaluated the distributions and types of UPCs associated with oncologists by specialty and assessed oncologist characteristics associated with UPCs. METHODS This retrospective study reviewed UPCs associated with US radiation oncologists (ROs), medical oncologists (MOs), and surgical oncologists (SOs) from 35 health care systems from 2015 to 2018. Average total UPCs were compared by specialty in addition to sex, medical school graduation year, degree, medical school location, residency location, practice setting, and practice region. For continuous variables, linear regression was used to test for an association with total complaints. RESULTS The study included 1576 physicians: 318 ROs, 1020 MOs, and 238 SOs. The average number of UPCs per physician was different and depended on the oncologic specialty: ROs had significantly fewer complaints (1.28; 95% confidence interval [CI], 1.02‐1.54) than MOs (3.81; 95% CI, 3.52‐4.10) and SOs (6.89; 95% CI, 5.99‐7.79; P < .0001). In a multivariable analysis, oncologic specialty, recency of graduation, and academic practice were predictive of higher total UPCs (P < .05). UPCs described concerns with care and treatment (42.8%), communication (26.4%), accessibility (17.5%), concern for patient (10.3%), and billing (2.9%). CONCLUSIONS ROs had significantly fewer complaints than MOs and SOs and may have a lower risk of malpractice claims as a group. In addition to oncologic specialty, a more recent year of medical school graduation and working at an academic center were independent risk factors for UPCs. Further research is needed to clarify the reasons underlying these associations and to identify interventions that decrease UPCs and associated risks. LAY SUMMARY This study of 1576 oncologists found that radiation oncologists had significantly fewer complaints than medical oncologists, who in turn had significantly fewer complaints than surgical oncologists. Other characteristics associated with more patient complaints included recency of medical school graduation and practice in an academic setting. Oncologists' patient complaints provide information that may have practical applications for patient safety and risk management. Understanding and addressing the characteristics that increase the risk for complaints could improve patients' experiences and outcomes.

Understanding Risk Factors for Complaints Against Pharmacists: A Content Analysis

“…From a broader perspective, this study sheds light on the significance of external environmental factors in shaping pharmacy practices. Previous research conducted in countries such as the USA, 50 Australia, 8 Demark, 51 and Canada 52 has also identified specific high-risk locations, corroborating our findings regarding the impact of geographic locations. Additionally, a Danish study examined 4 environmental characteristics and found a correlation between a higher tax base per citizen with less frequent malpractice litigation 53 .…”

Risk identification and prediction of complaints and misconduct against health practitioners: a scoping review

“…One predominant system factor identified in the studies was the academic/university settings. Regarding environmental factors, several studies conducted in the USA [ 29 , 31 , 55 , 68 ], Australia [ 1 , 2 , 51 , 56 ], Denmark [ 30 ], and Canada [ 85 ] examined the relationship between geographic regions and the risk of complaints and misconduct. In addition, a Danish study found that General Practitioners serving lower-income patients were more likely to receive complaints or disciplinary board criticisms [ 50 ].…”

“…Three practical predictive tools have been developed for regulating health practitioners ( Table 3 ). The first tool is the CPPA PARS database developed in the USA [ 55 ]. This database generates a risk score and establishes a complaint-type profile for each physician through analysis of the complaint data, allowing institutions to identify physicians at higher risk [ 55 , 58 , 76 ].…”

“…The first tool is the CPPA PARS database developed in the USA [ 55 ]. This database generates a risk score and establishes a complaint-type profile for each physician through analysis of the complaint data, allowing institutions to identify physicians at higher risk [ 55 , 58 , 76 ]. The other tool is the Predicted Risk of New Event (PRONE) score, proposed and tested by Spittal et al .…”

“…One repeatedly validated factor in this realm is the presence of academic/university settings. Factors contributing to this might involve treating patients with complex diagnoses, additional research, teaching and administration responsibilities, and complex organizational structures [ 55 ].…”