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Master of Public Health

"Coworker Reports About Unprofessional Behavior in Plastic Surgery."

AUTHORS

White-Dzuro CG , Glassman GE , Patrinely JR , Walker S , Stratton S , Domenico HJ , Galloway M , Pichert JW , Perdikis G , Cooper WO , . Plastic and reconstructive surgery. 2022 12 9; ().

ABSTRACT

INTRODUCTION: Patient reports of unprofessional conduct by surgeons have been linked to outcomes of care, most notably in terms of post-procedure complications and increased risk for malpractice claims.While patient complaints may focus on communication, accessibility, rudeness, and care outcomes, coworkers are also positioned to observe and report unprofessional behaviors, including concerns related to delivery of competent medical care, clear and respectful communication, integrity, and responsibility. When physicians act unprofessionally towards colleagues, team performance worsens, and their practices are associated with both increased rates of malpractice claims and greater rates of patient complications. Using data from the Coworker Observation Reporting System (CORS) database, our team sought to compare rates of coworker concerns between plastic surgeons and other physicians (other surgical specialists and non-surgeons), as well as characterize whether plastic surgery subspecialties differed in their rates of complaints.

METHODS: Coworker concern data from January 1, 2014 to December 31, 2019 were retrieved from the Vanderbilt Center for Patient and Professional Advocacy’s (CPPA) Coworker Observation Reporting System (CORS®). Specialty was classified as plastic surgery, non-plastic surgical, and non-surgical, and the plastic surgery cohort was further characterized by sex, medical school graduation year, predominant practice type (reconstructive only, aesthetic only, or hybrid), and post-residency training (i.e., completion of a fellowship).

RESULTS: The study cohort included 34,170 physicians (302 plastic surgeons, 7,593 non-plastic surgeons, and 26,275 non-surgeons). A greater proportion of plastic surgeons (13.6%) had one or more coworker concerns compared to non-surgeons (10.8%) and non-plastic surgeons (6.1%) (p<.001, Figure 1). The most prevalent concern category reported for plastic surgeons was Clear and Respectful Communication. Among plastic surgeons who had no concerns vs. those who had at least one concern, there was no significant difference when comparing sex, medical school graduation year, predominant practice type, or post-residency training.

CONCLUSION: Plastic surgeons in this cohort study received more coworker reports than other surgeons and non-surgical physicians. These data may be used by institutions to identify plastic surgeons at risk for preventable post-procedure complications and intervene with peer feedback intended to promote self-regulation.

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