Physician misconduct is of serious concern to patient safety and quality of care. Currently, there are limited data on disciplinary proceedings involving internal medicine (IM) physicians.The aim of this study was to investigate the number and nature of disciplinary cases among IM physicians compared with those of other disciplined physicians.Our retrospective study reviewed information from all provincial Colleges of Physicians and Surgeons (CPS) and compiled a database of all disciplined physicians from 2000 to 2013 in Canada. Disciplinary rate differences (RDs) were calculated for IM physicians and compared with other physicians.From 2000 to 2013, overall disciplinary rates were low (9.6 cases per 10,000 physician years). There were 899 disciplinary cases, 49 of which involved 45 different IM physicians. IM physicians comprised 10.8% of all disciplined physicians and were disciplined at a lower rate than non-IM physicians, incurring 5.18 fewer cases per 10,000 physician years than other physicians (95% confidence interval [CI] 3.62–6.73; P < 0.001). They were significantly less likely to be disciplined for: unprofessional conduct (RD 1.16; CI 0.45–1.87; P = 0.001); unlicensed activity (RD 0.78; CI 0.37–1.19; P < 0.001); standard of care issues (RD 1.37; CI 0.49–2.26; P = 0.002); sexual misconduct (RD 1.65; CI 0.90–2.40; P < 0.001); miscellaneous (RD 0.80; CI 0.11–1.50; P = 0.020); mental illness (RD 0.06; CI 0.01–0.12; P = 0.025); inappropriate prescribing (RD 0.74; CI 0.15–1.33; P = 0.010); and criminal conviction (RD 0.33; CI 0.00–0.65; P = 0.048). No significant differences were found with respect to unclear violations, fraudulent behavior/prevarication, or offenses involving drugs/alcohol (all RDs less than 0.32). IM physicians were also less likely to incur the following penalties: voluntary license surrender (RD 0.53; CI 0.37–0.69; P < 0.001); suspension (RD 2.39; CI 1.26–3.51; P < 0.001); retraining/assessment (RD 1.58; CI 0.77–2.39; P < 0.001); restriction (RD 1.60; CI 0.74–2.46; P < 0.001); other (RD 0.52; CI 0.07–0.97; P = 0.030); formal reprimand (RD 2.78; CI 1.77–3.79; P < 0.001); or fine (RD 3.28; CI 1.89–4.67; P < 0.001). No significant differences were found with respect to revocation or mandated counseling/rehabilitation (all RDs less than 0.46).Generally, disciplinary rates among physicians were low. Compared with other physicians, IM physicians have significantly lower disciplinary rates overall and are less likely to incur the majority of disciplinary offenses and penalties.
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机译:医师的不当行为严重关系到患者的安全和护理质量。目前,涉及内科(IM)医师的纪律程序数据有限,本研究旨在调查IM医师与其他纪律医师相比纪律病例的数量和性质。省内科医生与外科医生学院(CPS),并收集了2000年至2013年加拿大所有纪律医师的数据库。计算IM医师的纪律率差异(RDs),并将其与其他医师进行比较.2000年至2013年,总体纪律率较低(每10,000名医师年9.6例)。有899个学科案例,其中49个涉及45位不同的IM医师。 IM医师占所有受训医师的10.8%,其受训率低于非IM医师,每10,000医师年的发病率比其他医师少5.18(95%置信区间[CI] 3.62-6.73; P <0.001)。他们因以下原因受到纪律惩戒的可能性大大降低:(RD 1.16; CI 0.45–1.87; P = 0.001);未经许可的活动(RD 0.78; CI 0.37-1.19; P 0.001);护理标准(RD 1.37; CI 0.49–2.26; P = 0.002);性行为不当(RD 1.65; CI 0.90-2.40; P <0.001);杂项(RD 0.80; CI 0.11-1.50; P = 0.020);精神疾病(RD 0.06; CI 0.01-0.12; P = 0.025);处方不当(RD 0.74; CI 0.15–1.33; P = 0.010);和刑事定罪(RD 0.33; CI 0.00-0.65; P = 0.048)。在不清楚的违规,欺诈行为/推pre或涉及毒品/酒精的犯罪(所有RD均小于0.32)方面,未发现显着差异。 IM医师也不太可能受到以下处罚:自愿放弃执照(RD 0.53; CI 0.37–0.69; P <0.001);悬浮液(RD 2.39; CI 1.26-3.51; P 0.001);再培训/评估(RD 1.58; CI 0.77–2.39; P <0.001);限制(RD 1.60; CI 0.74-2.46; P <0.001);其他(RD 0.52; CI 0.07-0.97; P = 0.030);正式谴责(RD 2.78; CI 1.77–3.79; P <0.001);或优良(RD 3.28; CI 1.89-4.67; P 0.001)。在撤消或强制性咨询/康复方面(所有RD均小于0.46)没有发现显着差异。通常,医生的纪律率较低。与其他医师相比,即时消息医师的整体纪律处分率要低得多,并且不太可能招致大多数纪律违法和处罚。
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