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Patients’ complaints involving ophthalmologists in the province of Ontario, Canada: a 5-year review

Published:November 08, 2019DOI:https://doi.org/10.1016/j.jcjo.2019.08.007

      Abstract

      Objective

      To present an overview of complaints against ophthalmologists to the regulatory body in the province of Ontario, Canada, during a 5-year period.

      Design

      Retrospective cross-sectional study.

      Methods

      All completed complaints to the College of Physicians and Surgeons of Ontario (CPSO) involving ophthalmologists from January 2013 to May 2018 were reviewed. Data regarding the prevalence of complaints, physician characteristics, practice location, reason of complaint, and outcomes as decided by the Inquiries, Complaints and Reports Committee (ICRC) were collected. Identified concerns were classified across 3 domains: clinical care and treatment, professionalism and conduct, and practice management.

      Results

      There were 372 complaints involving 211 ophthalmologists out of 448 practicing ophthalmologists in Ontario. A total of 933 issues were raised in the 372 complaints. Complaints related to clinical care and treatment were most common (76.3%), followed by professionalism and conduct (55.4%) and practice management (24.7%). Within these domains, the 5 largest subcategories in order of occurrence were communication, billing practices, consent, procedural mishap, and documentation. Of the 372 investigations, the ICRC took some form of action in 117 cases (31.4%). The most common actionable decisions issued by the ICRC were advice (19.1%), caution (6.2%), and participation in a specified continuing educational or remediation program (3.5%). Four cases (1.1%) were referred to the Discipline Committee.

      Conclusions

      Almost half of practicing ophthalmologists in Ontario (47%) received at least one formal CPSO complaint within the 5-year study period. Communication was the most common issue raised in complaints.
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      References

        • Mavroforou A.
        • Michalodimitrakis E.
        Physicians’ liability in ophthalmology practice.
        Acta Ophthalmol Scand. 2003; 81: 321-325
        • Jena A.B.
        • Seabury S.
        • Lakdawalla D.
        • Chandra A.
        Malpractice risk according to physician specialty.
        N Engl J Med. 2011; 365: 629-636
        • Tomkins C.
        Over 120 years of defending ophthalmologists.
        Br J Ophthalmol. 2006; 90: 1084-1085
        • Ali N.
        A decade of clinical negligence in ophthalmology.
        BMC Ophthalmol. 2007; 7: 20
        • Mathew R.G.
        • Ferguson V.
        • Hingorani M.
        Clinical negligence in ophthalmology: fifteen years of National Health Service Litigation Authority data.
        Ophthalmology. 2013; 120: 859-864
        • The College of Physicians and Surgeons of Ontario
        Managing low risk complaints.
        Dialogue. 2018; 14: 9-10
        • Kohanim S.
        • Sternberg P.
        • Karrass J.
        • Cooper W.O.
        • Pichert J.W.
        Unsolicited patient complaints in ophthalmology.
        Ophthalmology. 2016; 123: 234-241
        • Simpson M.
        • Buckman R.
        • Stewart M.
        • et al.
        Doctor-patient communication: the Toronto consensus statement.
        BMJ. 1991; 303: 1385-1387
        • Levinson W.
        • Roter D.L.
        • Mullooly J.P.
        • Dull V.T.
        • Frankel R.M.
        Physician-patient communication: the relationship with malpractice claims among primary physicians and surgeons.
        JAMA. 1997; 277: 553-559
        • Munn I.
        Poor communication main source of patient complaints in Maritimes, registrars report.
        Can Med Assoc J. 1990; 143: 552-554
        • Stewart M.A.
        Effective physician-patient communication and health outcomes: a review.
        Can Med Assoc J. 1995; 152: 1423-1433
        • Tena Tamayo C.
        • Ahued J.R.
        Recommendations to improve quantity of obstetrics care.
        Ginec Obstet Mex. 2003; 71: 409-420
      1. Complaints about doctors rarely lead to formal discipline. www.cbc.ca/news/canada/manitoba/doctors-physicians-disciplinary-action-canada-1.3422953. Accessed April 8, 2019.

        • Daneshparvar H.R.
        • Javadian A.
        Malpractice complaints against ophthalmologists referred to the state of legal medicine organization in Iran.
        Iran J Ophthalmol. 2008; 20: 4-8
      2. Uninsured services: billing and block fees. www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Uninsured-Services-Billing-and-Block-Fees. Accessed July 8, 2019.

        • Menéndez-De-Lucas J.A.
        • Luque-Mialdea F.
        • Molına-Seoane V.
        Ophthalmology complaints in Spain.
        Arch Soc Esp Oftalmol. 2009; 84: 459-468
        • Wasfy I.A.
        • Wasfy E.I.
        • Aly T.A.
        • Abd-Elsayed A.A.
        Ophthalmic medicolegal cases in Upper Egypt.
        Int Arch Med. 2009; 2: 1
      3. Ontario Physicians Human Resources Data Centre Report for 2015. www.ophrdc.org. Accessed November 23, 2018.