Unsolicited Patient Complaints Identify Physicians with Evidence of Neurocognitive Disorders

Abstract

Objectives: Determine whether words contained in unsolicited patient complaints differentiate physicians with and without neurocognitive disorders (NCD).

Methods: We conducted a nested case-control study using data from 144 healthcare organizations that participate in the Patient Advocacy Reporting System program. Cases (physicians with probable or possible NCD) and two comparison groups of 60 physicians each (matched for age/sex and site/number of unsolicited patient complaints) were identified from 33,814 physicians practicing at study sites. We compared the frequency of words in patient complaints related to an NCD diagnostic domain between cases and our two comparison groups.

Results: Individual words were all statistically more likely to appear in patient complaints for cases (73% of cases had at least one such word) compared to age/sex matched (8%, p < 0.001 using Pearson's χ² test, χ² = 30.21, df = 1) and site/complaint matched comparisons (18%, p < 0.001 using Pearson's χ² test, χ² = 17.51, df = 1). Cases were significantly more likely to have at least one complaint with any word describing NCD than the two comparison groups combined (conditional logistic model adjusted odds ratio 20.0 [95% confidence interval 4.9-81.7]).

Conclusions: Analysis of words in unsolicited patient complaints found that descriptions of interactions with physicians with NCD were significantly more likely to include words from one of the diagnostic domains for NCD than were two different comparison groups. Further research is needed to understand whether patients might provide information for healthcare organizations interested in identifying professionals with evidence of cognitive impairment.

Keywords: Cognitive impairment; aging physician; neurocognitive disorder; patient complaints; physician assessment.