Objective: To understand causes of patient dissatisfaction that result in complaints.
Design: Grievances received by the grievance committee between January 1, 1989, and January 1, 2000, were reviewed.
Setting: A 2-county area of North Carolina.
Subjects: Of 29 patients who filed grievances, the 9 male (31%) and 20 female (69%) patients had a mean (+/-SD) age of 39 (+/-19) years. In 18 instances, the patient consulted the physician less than 3 times (64%) before the complaint and in 8 instances more than 4 times (29%). Main outcome measures Allegations of the grievance and the committee's findings.
Results: Grievances fell into 5 categories: failure to fulfill expectations for examination and treatment (38%), failure to promptly diagnose (20%), rudeness (17%), producing excessive pain or practicing beyond the area of expertise (13%), and inappropriate behavior related to billings (10%). In 45% of the grievances, the committee found no breach of practice standards. In 17% of the cases, the physician resolved the grievance by apologizing, adjusting a bill, or completing insurance forms.
Conclusion: Most grievances were filed by younger women against newly encountered physicians and were related to inadequate communication or alleged delay in diagnosis.