title: Doctors' experiences and their perception of the most stressful aspects of complaints processes in the UK: an analysis of qualitative survey data.
abstract: To examine doctors' experiences of complaints, including which aspects are most stressful. We also investigated how doctors felt complaints processes could be improved.
  
  
  
  A qualitative study based on a cross-sectional survey of members of the British Medical Association (BMA). We asked the following: (1) Try to summarise as best as you can your experience of the complaints process and how it made you feel. (2) What were the most stressful aspects of the complaint? (3) What would you improve in the complaints system?
  
  
  
  We sent the survey to 95 636 doctors, and received 10 930 (11.4%) responses. Of these, 6146 had a previous, recent or current complaint and 3417 (31.3%) of these respondents answered questions 1 and 2. We randomly selected 1000 answers for analysis, and included 100 using the saturation principle. Of this cohort, 93 responses for question 3 were available.
  
  
  
  Doctors frequently reported feeling powerless, emotionally distressed, and experiencing negative feelings towards both those managing complaints and the complainants themselves. Many felt unsupported, fearful of the consequences and that the complaint was unfair. The most stressful aspects were the prolonged duration and unpredictability of procedures, managerial incompetence, poor communication and perceiving that processes are biased in favour of complainants. Many reported practising defensively or considering changing career after a complaint, and few found any positive outcomes from complaints investigations. Physicians suggested procedures should be more transparent, competently managed, time limited, and that there should be an open dialogue with complainants and policies for dealing with vexatious complaints. Some felt more support for doctors was needed.
  
  
  
  Complaints seriously impact on doctors' psychological wellbeing, and are associated with defensive practise. This is not beneficial to patient care. To improve procedures, doctors propose they are simplified, time limited and more transparent.
authors.affiliation: Queen Charlotte's & Chelsea Hospital, Imperial College London, London, UK Department of Development and Regeneration, KU Leuven, Leuven, Belgium Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Bourne
authors.affiliation: LUCAS, KU Leuven, Leuven, Belgium.
authors.forename: Joke
authors.initials: J
authors.lastname: Vanderhaegen
authors.affiliation: LUCAS, KU Leuven, Leuven, Belgium.
authors.forename: Renilt
authors.initials: R
authors.lastname: Vranken
authors.affiliation: iMinds Future Health Department, KU Leuven, Leuven, Belgium Department of Electrical Engineering-ESAT, KU Leuven, STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, Leuven, Belgium.
authors.forename: Laure
authors.initials: L
authors.lastname: Wynants
authors.affiliation: Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: Bavo
authors.initials: B
authors.lastname: De Cock
authors.affiliation: Doctors for Doctors, British Medical Association, London, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Peters
authors.affiliation: Department of Development and Regeneration, KU Leuven, Leuven, Belgium Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Timmerman
authors.affiliation: Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
authors.forename: Ben
authors.initials: B
authors.lastname: Van Calster
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Jalmbrant
authors.affiliation: LUCAS, KU Leuven, Leuven, Belgium KU Leuven, Academic Center for General Practice.
authors.forename: Chantal
authors.initials: C
authors.lastname: Van Audenhove
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003430:Cross-Sectional Studies; D003675:Defensive Medicine; D004644:Emotions; D006801:Humans; D000073397:Occupational Stress / Q000209:etiology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D057766:Policy; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: MEDICAL LAW; Physician impairment; Regulation