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Record W2032783867 · doi:10.1136/bmj.39525.658565.80

Complaints against doctors

2008· editorial· en· W2032783867 on OpenAlex
Paul Kinnersley, Adrian Edwards

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueBMJ · 2008
Typeeditorial
Languageen
FieldHealth Professions
TopicMedical Malpractice and Liability Issues
Canadian institutionsnot available
Fundersnot available
KeywordsMedicine

Abstract

fetched live from OpenAlex

Complaints against doctorsCould be reduced by identifying and remedying poor communication skills early on Clinical communication skills are at the heart of medical practice, and poor performance is an important factor in the origins of complaints and litigation. 1 2 A recent study from Canada shows that poorly performing doctors can be identified early in their careers and possibly given targeted support and appropriate further training. 3 Tamblyn and colleagues followed up a cohort of newly qualified doctors in Ontario and Quebec for two to 12 years. 3They found a link between both communication and quality of care scores on the clinical skills examination of the Medical Council of Canada (taken shortly after graduation) and subsequent complaints registered with the medical regulatory authorities.A decrease of two standard deviations in communication score on the examination was associated with one additional complaint per 100 years of practice.People whose scores of communication skills were in the bottom quartile had a significantly increased risk of subsequent complaints from patients (excess complaint rate 2.15 per 100 practice years compared with the three other quartiles).Although the rate of complaints per 100 years might seem low, complaints were made against 17% of doctors at least once during the average 10 year follow-up period.Factors that were significantly associated with increased numbers of complaints were the clinician being male and working in family practice or surgery (rather than general medicine).Most of these doctors would have received training in communication skills during their medical school training, although this may have been of variable quality, and they were well aware of the content of the clinical skills examination.Considerable resources are currently devoted to teaching and assessing the communication skills of medical students.The Calgary Cambridge guide is well established as a generic guide to consultations and the skills needed for effective communication. 4 Students are often tested for communication skills-for example, taking a history; exploring the patient's perspective, concerns, and expectations; explaining diagnoses and treatment; and discussing options for treatment or care.Students also cover specific tasks such as breaking bad news.Tamblyn and colleagues' results suggest that doctors whose communication skills need to be improved could be identified before problems are encountered in clinical practice.Stricter thresholds for passing graduate medical examinations or postgraduate qualifications could be enforced.However, as these researchers point out, the reliability of many assessments of communication skills is low (and lower than assessments of clinical skills, for example), especially if relatively few

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.032
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Research integrity, Insufficient payload (model declined to judge)
Consensus categoriesResearch integrity, Insufficient payload (model declined to judge)
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Editorial · Consensus signal: Editorial
Teacher disagreement score0.096
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.032
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0020.004
Insufficient payload (model declined to judge)0.0040.010

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.081
GPT teacher head0.488
Teacher spread0.407 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it