Halperin E C
Department of Radiation Oncology and Pediatrics Duke University Medical Center Box 3085 Durham, NC 27710, USA. halperin2radonc.duke.edu
West J Med. 2000 Oct;173(4):235-8. doi: 10.1136/ewjm.173.4.235.
To understand causes of patient dissatisfaction that result in complaints.
Grievances received by the grievance committee between January 1, 1989, and January 1, 2000, were reviewed.
A 2-county area of North Carolina.
Of 29 patients who filed grievances, the 9 male (31%) and 20 female (69%) patients had a mean (+/-SD) age of 39 (+/-19) years. In 18 instances, the patient consulted the physician less than 3 times (64%) before the complaint and in 8 instances more than 4 times (29%). Main outcome measures Allegations of the grievance and the committee's findings.
Grievances fell into 5 categories: failure to fulfill expectations for examination and treatment (38%), failure to promptly diagnose (20%), rudeness (17%), producing excessive pain or practicing beyond the area of expertise (13%), and inappropriate behavior related to billings (10%). In 45% of the grievances, the committee found no breach of practice standards. In 17% of the cases, the physician resolved the grievance by apologizing, adjusting a bill, or completing insurance forms.
Most grievances were filed by younger women against newly encountered physicians and were related to inadequate communication or alleged delay in diagnosis.
了解导致患者投诉的不满原因。
回顾了申诉委员会在1989年1月1日至2000年1月1日期间收到的申诉。
北卡罗来纳州的一个两县地区。
在29名提出申诉的患者中，9名男性（31%）和20名女性（69%），平均（±标准差）年龄为39（±19）岁。在18例中，患者在投诉前咨询医生少于3次（64%），在8例中咨询超过4次（29%）。主要观察指标申诉的指控和委员会的调查结果。
申诉分为5类：未达到检查和治疗期望（38%）、未能及时诊断（20%）、粗鲁（17%）、造成过度疼痛或超出专业领域执业（13%）以及与计费相关的不当行为（10%）。在45%的申诉中，委员会未发现违反执业标准的情况。在17%的案例中，医生通过道歉、调整账单或填写保险表格解决了申诉。
大多数申诉由年轻女性针对新接触的医生提出，且与沟通不足或诊断延误有关。
