Stanford Children's Health, Stanford, CA, USA.
Stanford University School of Medicine, Stanford, CA, USA.
Mayo Clin Proc. 2022 Sep;97(9):1680-1691. doi: 10.1016/j.mayocp.2022.03.005.
To evaluate the relationship between an adverse impact of work on physicians' personal relationships and unsolicited patient complaints about physician behavior - a well-established indicator of patient care quality.
We paired data from a physician wellness survey collected in April and May 2013 with longitudinal unsolicited patient complaint data collected independently from January 1, 2013, to December 31, 2016. Unsolicited patient complaints were used to calculate the Patient Advocacy Reporting System (PARS) score, an established predictor of clinical outcomes and malpractice suits. The primary outcome was PARS score tercile. Ordinal logistic regression mixed effects models were used to assess the association between the impact of work on a physician's personal relationships and PARS scores.
Of 2384 physicians eligible to participate, 831 (34.9%) returned surveys including 429 (51.6%) who consented for their survey responses to be linked to independent data and had associated PARS scores. In a multivariate model adjusting for gender and specialty category, each 1-point higher impact of work on personal relationships score (0-10 scale; higher score unfavorable) was associated with a 19% greater odds of being in the next higher PARS score tercile of unsolicited patient complaints (odds ratio, 1.19; 95% CI, 1.07-1.33) during the subsequent 4-year study period.
An adverse impact of work on physicians' personal relationships is associated with independently assessed, unsolicited patient complaints. Organizational efforts to mitigate an adverse impact of work on physicians' personal relationships are warranted as part of efforts to improve the quality of patient experience and malpractice risk.
评估工作对医生个人关系的负面影响与患者对医生行为的非自愿投诉之间的关系——这是非自愿投诉是患者护理质量的一个既定指标。
我们将 2013 年 4 月和 5 月收集的医生健康调查数据与 2013 年 1 月 1 日至 2016 年 12 月 31 日独立收集的纵向非自愿患者投诉数据进行配对。非自愿患者投诉用于计算患者倡导报告系统（PARS）评分，这是临床结果和医疗事故诉讼的既定预测指标。主要结果是 PARS 评分 tertile。使用有序逻辑回归混合效应模型评估工作对医生个人关系的影响与 PARS 评分之间的关联。
在符合条件的 2384 名医生中，有 831 名（34.9%）返回了调查，其中 429 名（51.6%）同意将其调查回复与独立数据相关联，并具有相关的 PARS 评分。在调整性别和专业类别的多变量模型中，个人关系评分（0-10 分，分数越高越不利）每增加 1 分，与随后 4 年研究期间非自愿患者投诉的下一个更高 PARS 评分 tertile的可能性增加 19%（比值比，1.19；95%置信区间，1.07-1.33）。
工作对医生个人关系的不利影响与独立评估的非自愿患者投诉有关。值得组织努力减轻工作对医生个人关系的不利影响，作为提高患者体验质量和医疗事故风险的努力的一部分。
