The medical complaints and disciplinary process in New Zealand: doctors' suggestions for change.
OBJECTIVE
To document New Zealand doctors' opinions about the complaints and disciplinary process, and to develop a proposal for change.


METHODS
A cross-sectional survey of New Zealand doctors randomly selected to include vocationally registered general practitioners, vocationally registered hospital-based specialists, and general registrants. Qualitative (thematic) analysis of written responses was used to categorise doctors' ideas about the complaints system, and to develop a proposal for change


RESULTS
453 doctors responded to the survey. Respondents were aware of the complexity of medicine, the fallibility of doctors, and of tension between societal expectations of care and their ability to meet those expectations. They perceived a societal culture of blame, and indicated that complaints should provide an opportunity for learning (for both complainants and doctors to be heard), and for a satisfactory outcome to be achieved for both doctors and complainants. They indicated that complaints should be resolved rapidly, that frivolous and vexatious complaints should be identified early in the process, and that the role of the media should be minimised. They indicated that the complaints process should be transparent, with complaints tribunals using appropriate advisors and standards of judgment. The proposal for change was a single point of entry for all complaints.


CONCLUSIONS
New Zealand doctors are aware of the nature of the practice of medicine, and the sociopolitical context of the delivery of care. They support the notion of a Complaints Tribunal providing a single point of entry for all complaints, and which uses a process that is transparently appropriate for both doctors and complainants.
Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. wayne.cunningham@stonebow.otago.ac.nz
Wayne
W
Cunningham
D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D018166:Health Care Reform; D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence; D009520:New Zealand; D017060:Patient Satisfaction; D010820:Physicians / Q000523:psychology*; D011364:Professional Practice / Q000331:legislation & jurisprudence / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence / Q000458:organization & administration; D011795:Surveys and Questionnaires