Unsolicited Patient Complaints among Otolaryngologists. (May 2019)

• Record Type: Journal Article
• Authors: Nassiri, Ashley M.; Pichert, James W.; Domenico, Henry J.; Galloway, Mitchell B.; Cooper, William O.; Bennett, Marc L.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 160:Number 5(2019)
• Page Start: 810
• Page End: 817
• Publication Date: 2019-05
• Subjects: patient complaints -- otolaryngology -- patient safety -- quality improvement -- malpractice risk -- peer-comparative feedback; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599818823706
• Languages: English
• ISSNs: 0194-5998

Abstract

Objectives: To analyze unsolicited patient complaints (UPCs) among otolaryngologists, identify risk factors for UPCs, and determine the impact of physician feedback on subsequent UPCs. Methods: This retrospective study reviewed UPCs associated with US otolaryngologists from 140 medical practices from 2014 to 2017. A subset of otolaryngologists with high UPCs received peer-comparative feedback and was monitored for changes. Results: The study included 29, 778 physicians, of whom 548 were otolaryngologists. UPCs described concerns with treatment (45%), communication (19%), accessibility (18%), concern for patients and families (10%), and billing (8%). Twenty-nine (5.3%) otolaryngologists were associated with 848 of 3659 (23.2%) total UPCs. Male sex and graduation from a US medical school were statistically significantly associated with an increased number of UPCs ( P = .0070 and P = .0036, respectively). Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention ( P = .049). Twenty otolaryngologists (69%) categorized as "responders" reduced the number of complaints an average of 45% in the first 2 years following intervention. Discussion: Physician demographic data can be used to identify otolaryngologists with a greater number of UPCs. Most commonly, UPCs expressed concern regarding treatment. Peer-delivered, comparative feedback can be effective in reducing UPCs in high-risk otolaryngologists. Implications for Practice: Systematic monitoring and respectful sharing of peer-comparative patient complaint data offers an intervention associated with UPCs and concomitant malpractice risk reduction. Collegial feedback over time increases the response rate, but a small proportion of physicians will require directive interventions.