Study results

• 1,116 complaints were filed for 3,424 physicians.
• 696 complaints were retained after investigation.
• 17.1% of the physicians had at least one retained complaint.
• 81.9% of the retained complaints were for communication or quality-of-care problems.
• Communication problems in management and inappropriate treatment/follow-up were the most common causes of quality-of-care complaints.
• A decrease in communication score was associated with a 38 percent increase in the complaint rate.
• The patient-physician communication score in the clinical skills examination significantly predicted retained complaints.

“Our results provide some feedback for medical educators and licensing authorities. Our study supports the predictive validity of providing a standardized assessment of communication skills prior to entry into practice. Current examinations could be modified to test these attributes more efficiently and at earlier points in the training process. Future research should examine whether remediation of communication problems can reduce complaints, and whether other indicators of the quality of practice could be assessed by a clinical skills examination.” ³

The authors summarized:

“We found that communication and clinical decision-making ability were important predictors of future complaints to regulatory authorities. Current examinations could be modified to test these attributes more efficiently and at earlier points in the training process. Future research should examine whether remediation of communication problems can reduce complaints, and whether other indicators of the quality of practice could be assessed by a clinical skills examination.”

In an accompanying editorial, Gregory Makoul, Ph.D., and Raymond H. Curry, M.D., of the Northwestern University Feinberg School of Medicine, Chicago, commented on what can be done regarding communication skills:

“In terms of communication, initiatives could include more systematically assessing interpersonal skills during the admissions process, better connecting clerkship and residency experiences to earlier training in communication skills, and ensuring that clinical skills assessments include a communication component. The momentum is building. More medical schools are adopting a competency-based approach that features interpersonal and communication skills, paralleling the framework that is in place for residency programs and for maintenance of certification.”