Objectives: To analyze unsolicited patient complaints (UPCs) among otolaryngologists, identify risk factors for UPCs, and determine the impact of physician feedback on subsequent UPCs.
Methods: This retrospective study reviewed UPCs associated with US otolaryngologists from 140 medical practices from 2014 to 2017. A subset of otolaryngologists with high UPCs received peer-comparative feedback and was monitored for changes.
Results: The study included 29,778 physicians, of whom 548 were otolaryngologists. UPCs described concerns with treatment (45%), communication (19%), accessibility (18%), concern for patients and families (10%), and billing (8%). Twenty-nine (5.3%) otolaryngologists were associated with 848 of 3659 (23.2%) total UPCs. Male sex and graduation from a US medical school were statistically significantly associated with an increased number of UPCs ( P = .0070 and P = .0036, respectively). Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention ( P = .049). Twenty otolaryngologists (69%) categorized as "responders" reduced the number of complaints an average of 45% in the first 2 years following intervention.
Discussion: Physician demographic data can be used to identify otolaryngologists with a greater number of UPCs. Most commonly, UPCs expressed concern regarding treatment. Peer-delivered, comparative feedback can be effective in reducing UPCs in high-risk otolaryngologists.
Implications For Practice: Systematic monitoring and respectful sharing of peer-comparative patient complaint data offers an intervention associated with UPCs and concomitant malpractice risk reduction. Collegial feedback over time increases the response rate, but a small proportion of physicians will require directive interventions.
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http://dx.doi.org/10.1177/0194599818823706 | DOI Listing |
Vet Rec
December 2024
Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, University of Veterinary Sciences Brno, Brno, Czech Republic.
Background: There are currently few reports on the normal urinary protein-to-creatinine (UPC) ratio of guinea pigs, and there is little information on the effects of age and sex on this parameter.
Methods: Urinary protein and creatinine concentrations were measured in a total of 161 clinically healthy guinea pigs, and the UPC ratio was subsequently calculated. The effect of age and sex on these parameters was assessed using Mann-Whitney U tests.
Clin Transl Med
December 2024
Université de Poitiers, INSERM IRMETIST U1313, CHU de Poitiers, Service de Biochimie, Poitiers, France.
: Among strategies to limit ischemia/reperfusion (IR) injuries in transplantation, cell therapy using stem cells to condition/repair transplanted organs appears promising. We hypothesized that using a cell therapy based on extracellular vesicles (EVs) derived from urine progenitor cells (UPCs) during hypothermic and normothermic machine perfusion can prevent IR-related kidney damage. We isolated and characterized porcine UPCs and their extracellular vesicles (EVs).
View Article and Find Full Text PDFJ Arthroplasty
October 2024
Department of Orthopaedic Surgery, Duke University, Durham, North Carolina.
Background: This study aimed to describe the management and outcomes of aseptic revision total hip arthroplasty (arTHA) with unsuspected intraoperative positive cultures (UPCs) compared to those with sterile cultures.
Methods: A single tertiary center's institutional database was retrospectively reviewed for arTHA from January 2013 to October 2023. Preoperative Musculoskeletal Infection Society scores were assigned to patients based on available infectious workup, and those who met the criteria for periprosthetic joint infection (PJI), received antibiotic spacers, or had less than 1-year follow-up were excluded.
Bone Jt Open
October 2024
University College Hospital, London, UK.
Aims: The outcomes of patients with unexpected positive cultures (UPCs) during revision total hip arthroplasty (THA) and total knee arthroplasty (TKA) remain unknown. The objectives of this study were to establish the prevalence and infection-free implant survival in UPCs during presumed aseptic single-stage revision THA and TKA at mid-term follow-up.
Methods: This study included 297 patients undergoing presumed aseptic single-stage revision THA or TKA at a single treatment centre.
Int Orthop
December 2024
Helios ENDO-Klinik, Holstenstraße 2, 22767, Hamburg, Germany.
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