Barnhoorn Pieter C, Essers Geurt Tjm, Nierkens Vera, Numans Mattijs E, van Mook Walther Nka, Kramer Anneke Wm
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
The Netherlands' Network of the GP Specialty Training Institutes, Utrecht, The Netherlands.
BJGP Open. 2021 Jun 30;5(3). doi: 10.3399/BJGPO.2020.0168. Print 2021 Jun.
Professionalism is a key competence for physicians. Patient complaints provide a unique insight into patient expectations regarding professionalism. Research exploring the exact nature of patient complaints in general practice, especially focused on professionalism, is limited.
To characterise patient complaints in primary care and to explore in more detail which issues with professionalism exist.
DESIGN & SETTING: A retrospective observational study in which all unsolicited patient complaints to a representative out-of-hours general practice (OOH GP) service provider in The Netherlands were analysed over a 10-year period (2009-2019).
Complaints were coded for general characteristics and thematically categorised using the CanMEDS Physician Competency Framework (CanMEDS) as sensitising concepts. Complaints categorised as professionalism were subdivided using open coding.
Out of 746 996 patient consultations (telephone, face-to-face, and home visits) 484 (0.065%) resulted in eligible complaint letters. The majority consisted of two or more complaints, resulting in 833 different complaints. Most complaints concerned GPs (80%); a minority (19%) assistants. Thirty-five per cent concerned perceived professionalism lapses of physicians. A rich diversity in the wording of professionalism lapses was found, where was mentioned most often. Forty-five per cent related to medical expertise, such as missed diagnoses or unsuccessful clinical treatment. Nineteen per cent related to management problems, especially waiting times and access to care. Communication issues were only explicitly mentioned in 1% of the complaints.
Most unsolicited patient complaints were related to clinical problems. A third, however, concerned professionalism issues. Not being taken seriously was the most frequent mentioned theme within the professionalism category.
专业素养是医生的一项关键能力。患者投诉能让我们深入了解患者对专业素养的期望。关于全科医疗中患者投诉的确切性质，尤其是聚焦于专业素养的研究有限。
描述初级医疗中的患者投诉特征，并更详细地探究存在哪些专业素养问题。
一项回顾性观察研究，对荷兰一家具有代表性的非工作时间全科医疗（OOH GP）服务提供商在10年期间（2009 - 2019年）收到的所有主动患者投诉进行分析。
对投诉进行一般特征编码，并使用加拿大医学教育方向和角色框架（CanMEDS）作为敏感概念进行主题分类。归类为专业素养的投诉使用开放编码进一步细分。
在746996次患者咨询（电话、面对面和家访）中，有484次（0.065%）产生了符合条件的投诉信。大多数投诉包含两项或更多投诉，共计833项不同投诉。大多数投诉涉及全科医生（80%）；少数（19%）涉及助理。35%的投诉涉及对医生专业素养缺失的认知。发现专业素养缺失的表述丰富多样，其中 被提及的频率最高。45%与医学专业知识相关，如漏诊或临床治疗未成功。19%与管理问题相关，尤其是等待时间和获得医疗服务的机会。沟通问题仅在1%的投诉中被明确提及。
大多数主动患者投诉与临床问题相关。然而，三分之一的投诉涉及专业素养问题。未被认真对待是专业素养类别中最常被提及的主题。
