title: Analysis of complaints to a tertiary care pain clinic over a nine-year period.
abstract: BACKGROUND
  The present study is the result of an internal audit and examines the profiles of complainants and the sources and nature of complaints toward the staff in a tertiary care pain clinic, the Comprehensive Pain Program of the Toronto Western Hospital in Toronto, Ontario.
  
  
  METHODS
  All sources of complaints over a nine-year period were reviewed, which included the following: Toronto Western Hospital Patient Relations (PR) records, with a subset of the files qualitatively analyzed in depth regarding the nature of complaints and complainants; complaints that bypassed PR and were addressed directly to the program director against members of the staff; complaints to the College of Physicians and Surgeons of Ontario; and complaints recorded anonymously at rateMDs.com.
  
  
  RESULTS
  Although the prevalence of PR complaints was very low (1.73 complaints per 1000 visits), several other sources of complaints were identified. The typical complainant was a Canadian-born woman acting on her behalf or on behalf of a family member. More than one-half of the complaints were directed against the physicians regarding their opinion of psychological factors augmenting the patient's presentation and/or inappropriate use of opioids. Defensive techniques instituted by the Comprehensive Pain Program staff in reaction to the complaints are discussed, and pertinent literature is reviewed.
  
  
  CONCLUSIONS
  The present study is the first to examine the nature of complaints and complainants from a Canadian pain clinic. Further studies are needed to explore the complex issues of patient and staff interactions, and complaints in the era of 'patient-centred care'.
authors.affiliation: Pain Program, Toronto Western Hospital, University Health Network and University of Toronto Centre for the Study of Pain, Toronto, Ontario. angela.mailis@uhn.on.ca
authors.forename: Angela
authors.initials: A
authors.lastname: Mailis-Gagnon
authors.forename: Keith
authors.initials: K
authors.lastname: Nicholson
authors.forename: Luis
authors.initials: L
authors.lastname: Chaparro
mesh_terms: D003625:Data Collection; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D018710:Pain Clinics / Q000706:statistics & numerical data*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012737:Sex Factors