Authors: Rini Saha, Anna Kabanovski, Susan Klejman, Edward Margolin, Yvonne M. Buys

Author Disclosure Block: R. Saha: None. A. Kabanovski: None. S. Klejman: None. E. Margolin: None. Y.M. Buys: Any direct financial payments including receipt of honoraria; Argentum Pharmaceuticals, Bausch and Lomb (Consultant).

Abstract Body:

Purpose: Patient concerns represent opportunities for improvement in ophthalmology care. This study’s objective is to present an overview of complaints against ophthalmologists in the province of Ontario, Canada.
Study Design: Cross-sectional study
Methods: All resolved complaints to the College of Physicians and Surgeons of Ontario (CPSO) against ophthalmologists from January 2013 to May 2018 were analysed. Data regarding the prevalence of complaints, physician characteristics, incident location, reason of complaint and outcomes as decided by the Inquiries, Complaints and Reports Committee (ICRC) was collected. Complaints were classified across three domains: clinical care and treatment, professionalism and conduct and practice management.
Results: During the study period there were 372 complaints against 211 ophthalmologists (82.9% male, median age 45-54 years) out of 448 practicing ophthalmologists (72.1% male, median age 45-54 years) in Ontario. Of the 211 complained-against ophthalmologists 125 (60%) had one complaint, 49 (23%) had 2 complaints and 37 (17.5%) and 3 or more complaints. 237 (53%) ophthalmologists had no complaints during this period. Most incidents (49.8%) occurred in a specialist’s office and hospital settings (31.8%). A total of 896 issues were raised in 372 complaints, on average 2.4 issues per complaint. Complaints related to clinical care and treatment were most common (76.3%), followed by professionalism and conduct (55.4%) and practice management (24.7%). Within these domains, the five largest subcategories in order of occurrence were communication, billing practices, consent, procedural mishap and documentation. Of the 372 investigations, the ICRC took some form of action in 117 cases (31.4%) which was significantly less compared to investigations involving non-ophthalmologists during this period which resulted in some form of action in 40% of cases, p<0.05. The most common decisions issued by the ICRC were advice/remedial agreement (19.1%), caution (6.2%), and participation in a specified continuing educational or remediation program (3.5%). 4 cases (1.1%) were referred to the discipline committee.
Conclusions: Almost half of practicing ophthalmologists in Ontario (47%) had at least one formal CPSO complaint within the 4.5 year study period. Communication was the most common issue raised in complaints thus improving communication skills is an important goal for all practicing ophthalmologists in order to minimize the chances of receiving a formal complaint.