The effect on medical practice of disciplinary complaints: potentially negative for patient care.
OBJECTIVE
To explore the personal and professional effect on general practitioners (GPs) of receiving a complaint against them to the (former) Medical Practitioners Disciplinary Committee, when the complaint did not proceed to a formal hearing.


METHODS
Ten GPs were interviewed by telephone, following an enrollment procedure that protected identities from the interviewer. Qualitative (thematic) analysis of indepth interviews was used to categorise doctors' perceived effects of complaints on practice and to develop a theory on why such effects should occur.


RESULTS
Receipt of a complaint had both short- and long-term effects on the doctor, and on their views of patients, society and the disciplinary process. There were immediate negative emotional responses that were sustained in the long-term in a way that adversely effected doctor-patient relationships beyond the relationship with the original complainant. Doctors reported short-term changes in their practice of medicine, with reduced ability to work confidently and decisively. Doctors also reported altered practice in the long-term in the direction of defensive medicine, by withdrawing from providing some services and avoiding perceived at-risk activities.


CONCLUSIONS
The impact of a complaint on the self of the doctor suggests a shame response. There may be a need for the relevant professional college to establish a rapid response 'crash team' to minimize the negative personal and professional effects of a complaint, even when the complaint does not proceed to a formal hearing.
Cunningham
W
W
Department of General Practice, Dunedin School of Medicine, Dunedin.
Dovey
S
S
D001291:Attitude of Health Personnel; D003419:Crisis Intervention / Q000458:organization & administration; D003675:Defensive Medicine / Q000458:organization & administration*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice; D009520:New Zealand; D009936:Organizational Innovation; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D012308:Risk Management / Q000458:organization & administration; D012649:Self Concept; D012944:Social Support; D011795:Surveys and Questionnaires