Sex differences in medico-legal action against doctors: a systematic review and meta-analysis

BMC Medicine

Research Article

Henry W. W. Potts¹  Jane Dacre²  Katherine Woolf³  Clare Wadlow³  Emily Unwin³ 

[1] Institute of Health Informatics, University College London, 222 Euston Road, NW1 2DA, London, UK;Royal College of Physicians, 11 St Andrews Place, NW1 4LE, London, UK;UCL Medical School, University College London, Royal Free Hospital, NW3 2PF, London, UK;

关键词: Disciplinary action;    Malpractice;    Medical education;    Medical regulatory boards;    Meta-analysis;    Systematic review;   

DOI  :  10.1186/s12916-015-0413-5

 received in 2015-05-20, accepted in 2015-06-30,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThe relationship between male sex and poor performance in doctors remains unclear, with high profile studies showing conflicting results. Nevertheless, it is an important first step towards understanding the causes of poor performance in doctors. This article aims to establish the robustness of the association between male sex and poor performance in doctors, internationally and over time.MethodsThe electronic databases MEDLINE, EMBASE, and PsycINFO were searched from inception to January 2015. Backward and forward citation searching was performed. Journals that yielded the majority of the eligible articles and journals in the medical education field were electronically searched, along with the conference and poster abstracts from two of the largest international medical education conferences. Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors’ sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation.ResultsOverall, 32 reports examining the association between doctors’ sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses.ConclusionMale doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time.

【 授权许可】

CC BY   
© Unwin et al. 2015