- Younger providers and clinicians with less practice experience may incur higher patient complaint rates than their older clinician colleagues, highlighting that clinician age might be tied to patient satisfaction, according to a study published in JAMA Ophthalmology.
Patient complaints provide an important view into the patient experience by highlighting key areas for improvement, the researchers said.
“Unsolicited patient complaints give physicians and their health care system, hospital or medical group leaders opportunities to provide ‘service recovery’ to address what patients perceive to be wrong in their health care encounter,” the team explained.
Complaints can also help predict likelihood of malpractice lawsuits. When a practice assesses patient complaints, it can conduct patient satisfaction interventions with providers. There have been observed decreases in lawsuits when practices conduct satisfaction interventions, the research team reported.
Industry experts have recently given much attention to the correlation between clinician age and patient experience, the researchers noted. While some experts claim age bias against providers can be detrimental to patient care, others have asserted that understanding how patients experience care with providers of different ages gives insights into key areas for improvement.
“The associations between performance or competence and physician age have received national attention because age also appears to be related to lawsuit risk and discipline-specific skills,” the research team explained. “Lawsuit risk appears to be highest during the first 10 years of practice.”
An assessment of patient complaints among over 1,300 ophthalmologists affiliated with Vanderbilt University Medical Center’s Patient Advocacy Reporting System showed that age may play a factor behind patient complaints and lawsuits against younger doctors.
The research team looked at ophthalmologists who had graduated from medical school prior to 2010 and stratified those clinicians into five age subsects. The team then looked at how long it took for a provider to receive his first patient complaint.
Coders categorized each complaint into the following areas: care and treatment, communication, access and availability, concern for patient and family, safety of environment, and billing.
The research team observed that older doctors took longer to receive their first patient complaints and received fewer patient complaints than younger clinician cohorts.
On average, it took providers 9.8 years to receive a patient complaint, but for younger clinicians it took as little as 5.5 years to receive a patient complaint.
Additionally, younger clinicians aged 31 to 40 and 41 to 50 were 2.36 and 1.73 times more likely to receive a complaint than clinicians over the age of 71, respectively.
“Early-career physicians may be associated with less time to first complaint and overall more UPCs owing to the challenges of mastering new clinical systems and how best to provide excellent attending-level care largely on their own,” the researchers posited.
“Moreover, because younger physicians may be more up-to-date with best practices, their UPCs may derive less from cognitive or technical deficits than from behavioral and confidence issues,” the team continued.
Younger clinicians also might have a subpar support staff, more “difficult patients,” and less expertise in handling more sensitive medical issues.
The researchers did acknowledge the concept of “survival bias.” It usually takes between 10 and 15 years for a provider to be driven out of practice from malpractice lawsuits or high risk of lawsuits. Younger clinicians have not yet reached this threshold, so they might have higher occurrences of patient complaints.
The researchers did not state that younger clinicians were not qualified to treat patients, nor did they indicate any sort of undue patient bias to explain the disparity in patient complaints.
Instead, the researchers stated that these findings suggest that patient complaints can help inform practice improvement efforts. Understanding which clinicians receive patient complaints and for which reasons will help target patient satisfaction interventions.
“Ophthalmologist age is significantly associated with receiving a patient complaint,” the researchers concluded. “These findings underscore the importance of including patients as health care team members because their observations can provide actionable information for individual physicians and leaders committed to providing the highest quality of care.”