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PSNet: Patient Safety Network
Journal Article

Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia.

Bismark MM, Spittal MJ, Gurrin LC, et al. BMJ quality & safety. 2013;22:532-40.

Although most patient safety efforts focus on identifying and addressing flawed systems, individual clinicians who cause recurrent problems—either through substandard clinical performance or overtly disruptive behavior—must be addressed as well. This analysis of an Australian national database revealed that just 3% of physicians accounted for nearly half of all complaints filed by patients, and relatively simple characteristics (including physician gender, clinical specialty, and number of prior complaints) predicted the likelihood that an individual clinician would be the subject of future complaints. These data, combined with prior research connecting medical school behavior to the risk of future disciplinary action, provide a means for regulatory authorities to predict problematic behavior by clinicians and point the way toward system-level solutions for problem doctors.