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Not so random: patient complaints and ‘frequent flier’ doctors
  1. Ron Paterson
  1. Correspondence to Professor Ron Paterson, Faculty of Law, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; r.paterson{at}

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Why complaints matter

Complaints matter: to the people who make them, usually as a last resort after the frustration of trying other avenues without success; to the person complained about, in whom the complaint may provoke a fierce reaction, ranging from shame to indignation; and to the agency required to handle the complaint, charged with resolving a problem when the parties’ recollections and objectives may be sharply divergent.

Complaints also matter to society. As long ago as 1644, John Milton said that ‘When complaints are freely heard, deeply considered, and speedily reformed, then this is the utmost bound of civil liberty attained that wise men look for.’1 Complaints are commonly referred to as ‘treasure’, providing valuable signals from consumers about quality deficits, enabling providers to identify and remedy problems and improve the quality of goods and services.2 For safety and quality researchers, complaints may be ‘canaries in the coal mine’, sounding an alert to deeper problems. Complaints also provide undiluted feedback on a patient's experience, an important measure of quality. Complainants usually want questions answered and problems fixed, and the ‘speedy reform’ referred to by Milton holds out the promise of resolution for individuals and improvement for the population.

In the early twenty-first century, handling complaints about public and private services has become a veritable industry. Over 70 countries now have an Ombudsman, a ‘grievance person’ to investigate complaints about maladministration by government agencies. Several countries, including the Australian states and territories and New Zealand, have statutory healthcare complaint commissions to deal with complaints about health professionals and healthcare organisations. Complaints by aggrieved patients have the potential to be an important window on healthcare quality.3

Bismark research findings

The databases of the Australian healthcare complaint commissions are fertile ground for researchers seeking to understand patient complaints. In a national study reported in this …

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