Complaint management and professional regulation

Also known as Patient complaints · Fitness to practise · Medical board notification · AHPRA notification · Open disclosure · Medicolegal complaints · Professional regulation · Defensive medicine · Second victim · Healthcare complaints

Exam-exhaustive fellowship reference on healthcare complaints versus claims versus regulatory notifications, why patients complain, complaint taxonomies, recurrent-complaint risk, open disclosure, local resolution, fitness-to-practise principles, second-victim harm and defensive medicine, psychiatrist-specific complaint drivers, and support/remediation pathways. FRANZCP-primary, globally tagged. Principles only — no invented statute numbers.

medium14 referencesUpdated 26 July 202613 min readVerification in progress

Practise this topic

10 MCQs

Meet the doctor

A registrar you supervise opens an envelope at 4pm on a Friday. A family has written to the health service about the ward round on the day before their father died. Two of the three allegations are about tone. The third is about a missed medication review.^[4]^[6]

By Monday she has drafted a four-page rebuttal, has not slept, and has asked to be taken off the acute roster. She has not yet spoken to anyone about the third allegation, which is the only one with clinical substance.^[3]^[12]^[14]

Examiners ask two questions about this envelope. What does the family actually want, and who is looking after the doctor? Most candidates answer neither.^[3]^[6]^[12]

References14Show

[1]Bismark MM, Spittal MJ, Gurrin LC, Ward M, Studdert DM Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia BMJ Qual Saf, 2013.PMID 23576774
[2]Spittal MJ, Bismark MM, Studdert DM The PRONE score: an algorithm for predicting doctors' risks of formal patient complaints using routinely collected administrative data BMJ Qual Saf, 2015.PMID 25855664
[3]Bourne T, Wynants L, Peters M, et al. The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey BMJ Open, 2015.PMID 25592686
[4]Reader TW, Gillespie A, Roberts J Patient complaints in healthcare systems: a systematic review and coding taxonomy BMJ Qual Saf, 2014.PMID 24876289
[5]Gillespie A, Reader TW The Healthcare Complaints Analysis Tool: development and reliability testing of a method for service monitoring and organisational learning BMJ Qual Saf, 2016.PMID 26740496
[6]Vincent C, Young M, Phillips A Why do people sue doctors? A study of patients and relatives taking legal action Lancet, 1994.PMID 7911925
[7]Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W Patients' and physicians' attitudes regarding the disclosure of medical errors JAMA, 2003.PMID 12597752
[8]Studdert DM, Mello MM, Gawande AA, et al. Claims, errors, and compensation payments in medical malpractice litigation N Engl J Med, 2006.PMID 16687715
[9]Cunningham W, Wilson H Complaints, shame and defensive medicine BMJ Qual Saf, 2011.PMID 21441601
[10]Nash LM, Kelly PJ, Daly MG, Walter G, van Ekert EH Australian doctors' involvement in medicolegal matters: a cross-sectional self-report study Med J Aust, 2009.PMID 19835537
[11]Nash LM, Walton MM, Daly MG, Kelly PJ, Walter G Perceived practice change in Australian doctors as a result of medicolegal concerns Med J Aust, 2010.PMID 21077813
[12]Seys D, Wu AW, Van Gerven E, et al. Health care professionals as second victims after adverse events: a systematic review Eval Health Prof, 2013.PMID 22976126
[13]Veness BG, Tibble H, Grenyer BF, Morris JM, Spittal MJ, et al. Complaint risk among mental health practitioners compared with physical health practitioners: a retrospective cohort study of complaints to health regulators in Australia BMJ Open, 2019.PMID 31874871
[14]Jain A, Ogden J General practitioners' experiences of patients' complaints: qualitative study BMJ, 1999.PMID 10364121