Department of Anesthesiology, Hospital for Sick Children, Toronto, Canada.
PLoS One. 2012;7(11):e50558. doi: 10.1371/journal.pone.0050558. Epub 2012 Nov 28.
The identification of health care professionals who are incompetent, impaired, exploitative or have criminal intent is important for public safety. It is unclear whether psychiatrists are more likely to commit medical misconduct offences than non-psychiatrists, and if the nature of these offences is different.
The aim of this study was to compare the characteristics of psychiatrists disciplined in Canada and the nature of their offences and disciplinary sentences for the ten years from 2000 through 2009 to other physicians disciplined during that timeframe.
Utilizing a retrospective cohort design, we constructed a database of all physicians disciplined by provincial licensing authorities in Canada for the ten years from 2000 through 2009. Demographic variables and information on type of misconduct violation and penalty imposed were also collected for each physician disciplined. We compared psychiatrists to non-psychiatrists for the various outcomes.
There were 82 (14%) psychiatrists of 606 physicians disciplined in Canada in the ten years from 2000 through 2009, double the national proportion of psychiatrists. Of those disciplined psychiatrists, 8 (9.6%) were women compared to 29% in the national cohort. A total of 5 (6%) psychiatrists committed at least two separate offenses, accounting for approximately 11% of the total violations. A higher proportion of psychiatrists were disciplined for sexual misconduct (OR 3.62 [95% Confidence Interval [CI] 2.45-5.34]), fraudulent behavior (OR 2.32 [95% CI 1.20-4.40]) and unprofessional conduct (OR 3.1 [95% CI 1.95-4.95]). As a result, psychiatrists had between 1.85-4.35 greater risk of having disciplinary penalties in almost all categories in comparison to other physicians.
Psychiatrists differ from non-psychiatrist physicians in the prevalence and nature of medical misconduct. Efforts to decrease medical misconduct by psychiatrists need to be conducted and systematically evaluated.
识别不称职、受损、剥削或有犯罪意图的医疗保健专业人员对公共安全很重要。目前尚不清楚精神科医生是否比非精神科医生更有可能犯医疗不当行为罪，以及这些罪行的性质是否不同。
本研究旨在比较 2000 年至 2009 年十年间在加拿大受纪律处分的精神科医生的特征，以及他们的犯罪性质和纪律处分判决，与同期受纪律处分的其他医生进行比较。
利用回顾性队列设计，我们构建了一个数据库，其中包含 2000 年至 2009 年十年间因医疗不当行为被省级许可机构纪律处分的所有医生。还收集了每位受纪律处分医生的人口统计学变量和不当行为违规类型以及所施加的处罚信息。我们将精神科医生与非精神科医生进行了比较。
在 2000 年至 2009 年十年间，加拿大共有 606 名受纪律处分的医生中，有 82 名（14%）是精神科医生，是全国精神科医生比例的两倍。在受纪律处分的精神科医生中，有 8 名（9.6%）是女性，而全国队列中的比例为 29%。共有 5 名（6%）精神科医生犯有至少两次单独的违法行为，占总违法行为的 11%左右。因性行为不当（OR 3.62 [95%置信区间 [CI] 2.45-5.34]）、欺诈行为（OR 2.32 [95% CI 1.20-4.40]）和不专业行为（OR 3.1 [95% CI 1.95-4.95]）而受到纪律处分的精神科医生比例较高。因此，与其他医生相比，精神科医生在几乎所有类别中都有 1.85-4.35 倍的纪律处分风险。
精神科医生与非精神科医生在医疗不当行为的发生率和性质上存在差异。需要对减少精神科医生医疗不当行为的努力进行并系统地评估。
