Association of Occupational Distress and Sleep-Related Impairment in Physicians With Unsolicited Patient Complaints

• Published in: Mayo Clinic proceedings Vol. 95; no. 4; pp. 719 - 726
• Main Authors: Welle, Dana, Trockel, Mickey T., Hamidi, Maryam S., Hickson, Gerald B., Menon, Nikitha K., Shanafelt, Tait D., Cooper, William O.
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01-04-2020; Frontline Medical Communications Inc; Elsevier Limited
• Subjects: Advocacy; Burnout; Complaints; Litigation; Malpractice; Medical centers; Medical malpractice; Medical schools; Mental depression; Patient advocacy; Patient satisfaction; Patients; Physicians; Response rates; Sleep; Surveys; Validity; PROMIS; PARS
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2019.09.025

To study the relationship between occupational distress and sleep-related impairment in physicians and unsolicited patient complaints.
We used deidentified data from an academic medical center’s physician survey administered in April and May of 2013 to perform a retrospective cohort study. Third-party stewards of the identifiable information regarding unsolicited patient complaints from January 1, 2013, through December 31, 2016, matched these data with corresponding physicians’ occupational distress data. Unsolicited patient complaints were used to calculate the Patient Advocacy Reporting System (PARS) score, a validated predictor of malpractice litigation risk and clinical outcomes. Physicians were grouped into 1 of 3 PARS risk categories based on previously defined thresholds: low risk (score of 0), intermediate risk (score of 1-12), or high risk (score ≥13).
Each 1-point increase in burnout and sleep-related impairment, on a 5-point scale, was associated with a 69% (odds ratio [OR], 1.69; 95% CI, 1.12-2.54) and 49% (OR, 1.49; 95% CI, 1.08-2.05) increased odds of being in the next higher PARS risk category, respectively, averaged across all 4 years. Professional fulfillment was a protective factor, associated with fewer unsolicited patient complaints. Each 1-point decrease in professional fulfillment was associated with a 68% (OR, 1.68; 95% CI, 1.16-2.44) increased odds of being in the next higher PARS risk category. The effect of depression on PARS risk category was not significant (OR, 1.33; 95% CI, 0.84-2.10).
Findings from this research suggest that occupational distress and sleep-related impairment in physicians are associated with unsolicited patient complaints.