Surgeon

What is it about Surgeons?

Michael Gorton AM

Surgeons are twice as likely to have claims made against them than physicians, according to the Medical Board of Australia data.

 

A recent retrospective study of notifications made to the Medical Board of Australia/AHPRA from 2011 to 2016 analysed the extent and nature of claims against surgeons compared to other specialities.

The study, “Why do surgeons receive more complaints than their physician peers?”, ANZ Journal of Surgery, 9 September 2017, also classified complaints according to their cause – treatment of procedures, other performance, professional conduct and health/impairment.

The rate of complaints against surgeons was 2.3 times the rate against physicians, and surgeons had a higher rate of complaint against each of the categories – treatment, performance, professional conduct and health.

Whilst obviously the nature of the treatment/performance by surgeons is more visible to the patient, and perhaps surgical outcomes are more visible as well, surgeons also received notifications which may reflect interpersonal skills, professional ethics and substance abuse – each of which were recognised at higher rates than other medical specialities.

Male surgeons were found to be at higher risk of complaint. Higher rates were also identified in some specialities; in orthopaedics, plastic surgery and neurosurgery.

Other noticeable determinates include an increase rate of complaint for older surgeons and surgeons in regional and rural areas.

The study identified that, compared with physicians, surgeons were ten times more likely to have complaints in relation to procedures/treatments. They were 1.5 times more likely to have complaints about fees, fraud, reports, certificates and communications.

Whilst the data may require greater analysis into the precise nature or grounds of complaint, it may be surmised that surgeons will receive more complaints for treatment and procedures because their adverse incidents are more visible and occasionally at `higher risk than their physician colleagues.

The data reflecting on poor communications skills and interpersonal skills resonates with some of the Royal Australasian College of Surgeons (RACS) survey in relation to discrimination, bullying and harassment. Accordingly, the RACS programs in relation to culture, awareness and respect may go to addressing some of the issues of interpersonal skills reflected in this data.

Additionally, the data does not necessarily reflect the outcomes of the complaints or notifications to the MBA/AHPRA. It is otherwise known that complaints to the MBA/AHPRA have fairly high rates of no further action being required – that is, no regulatory action is taken in relation to the complaint against a medical practitioner.

The “no further action required” rate in relation to surgeons in particular is not identified. The data does not either reflect on whether surgeons are more negligent or not and such data is more likely to be held by insurers and others involved in general complaint handling and claims. Nonetheless the data provides a basis for some assumptions about the nature of surgery, the training of surgeons and the culture of surgery in practice.

As noted, the data provides clear support for the ongoing work of the RACS “Building Respect in Surgery” campaign dealing with bullying and harassment.

For more information, please contact Michael Gorton AM, Principal on (03) 9609 1505.

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