Medical complaints against doctors don't improve the standard of patient care in New Zealand

Medical complaints made against doctors are not helping to improve the standard of patient care in New Zealand, according to half of the doctors who took part in a University of Otago study.

Of the 971 respondents, 89 per cent do not believe that most medical complaints are warranted, while 95 per cent support society's right to complain. About a third (34 per cent) of the respondents had received a complaint at some time in their career.

The study, carried out by Dr Wayne Cunningham from Dunedin School of Medicine's Department of General Practice, is published in the latest edition of the New Zealand Medical Journal.

"Not surprisingly, we found that one in three doctors who received a complaint against them lost trust and a sense of goodwill towards patients immediately after receiving the complaint," Dr Cunningham says. "They also felt angry, depressed, ashamed, guilty and experienced less enjoyment in practicing medicine.

"Doctors are well aware of the complexity of practising and the tensions between the limitations of medicine and the expectations of society. They also recognise the tensions between the rights and responsibilities of doctors and patients. However, there is no evidence that complaints improve the delivery of patient care."

On average, about 75% of dismissed complaints are dismissed within 12 months, and only 60% of upheld complaints are resolved within a 12 month period.

One hundred and forty eight respondents commented on the length of the complaints process and the need for more rapid resolutions. One doctor recalls: "I was devastated by the length of time it took to resolve. I contemplated suicide, leaving the profession, leaving New Zealand, etc. It was a very terrible time of my life and for many years it was very difficult to talk about it."

The results also show that 68 per cent of the study's doctors agree that the medical profession is capable of self regulation and 89 per cent say medical complaints should not be resolved in a court of law.

According to Dr Cunningham "there's significant support within the medical profession for a change to the structure of the complaints and disciplinary process. The respondents suggested that a single point of entry for all complaints was needed and that they should always receive consistent judgement.

"By focusing on doctors' education and improving systems of delivery of care, the complaints process has the potential to improve the well-being of society. What is needed is a process that is transparently fair to both doctors and complainants and recognises the complexity of medicine and of health care systems."

In the year to June 2003, the Office of the Health and Disability Commissioner received 488 complaints against medical practitioners, down from 571 in the year to June 2002 and 741 in the year to 2001.

http://www.otago.ac.nz/