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Medical malpractice in Norway: frequency and distribution of disciplinary actions for medical doctors 2011-2018
Martin B Harbitz1, Per Steinar Stensland2, Birgit Abelsen3
1Department of Community Medicine, UiT The Arctic University of Norway, Norwegian Centre for Rural Medicine, 9037, Tromsø, Norway. martin.b.harbitz@uit.no.
Background:
Physicians who perform unsafe practices and harm patients may be disciplined. In Norway, there are five types of disciplinary action, ranging from a warning for the least serious examples of malpractice to loss of licence for the most serious ones. Disciplinary actions always involve medical malpractice. The aims of this study were to investigate the frequency and distribution of disciplinary actions by the Norwegian Board of Health Supervision for doctors in Norway and to uncover nation-wide patient safety issues.
Methods:
We retrospectively investigated all 953 disciplinary actions for doctors given by the Board between 2011 and 2018. We categorized these according to type of action, recipient's profession, organizational factors and geographical location of the recipient. Frequencies, cross tables, rates and linear regression were used for statistical analysis.
Results:
Rural general practitioners received the most disciplinary actions of all doctors and had their licence revoked or restricted 2.1 times more frequently than urban general practitioners. General practitioners and private specialists received respectively 98.7 and 91.0 disciplinary actions per 1000 doctors. Senior consultants and junior doctors working in hospitals received respectively 17.0 and 6.4 disciplinary actions per 1000 doctors. Eight times more actions were received by primary care doctors than secondary care doctors. Doctors working in primary care were given a warning 10.6 times more often and had their licence revoked or restricted 4.6 times more often than those in secondary care.
Conclusion:
The distribution and frequency of disciplinary actions by the Norwegian Board of Health Supervision clearly varied according to type of health care facility. Private specialists and general practitioners, especially those working in rural clinics, received the most disciplinary actions. These results deserve attention from health policy-makers and warrant further studies to determine the factors that influence medical malpractice. Moreover, the supervisory authorities should assess whether their procedures for reacting to malpractice are efficient and adequate for all types of physicians working in Norway.
Insights
Physicians in rural areas, particularly general practitioners and private specialists, face more disciplinary actions in Norway. This highlights potential patient safety issues in primary care settings that require policy attention.
Area of Science:
- Medical Law and Ethics
- Health Services Research
- Patient Safety
Background:
- Physicians performing unsafe practices may face disciplinary actions in Norway.
- Actions range from warnings to license revocation, addressing medical malpractice.
- The study investigates disciplinary actions to identify patient safety issues.
Purpose of the Study:
- To analyze the frequency and distribution of disciplinary actions against doctors in Norway.
- To identify patterns in disciplinary actions based on physician type and location.
- To uncover nationwide patient safety concerns.
Main Methods:
- Retrospective analysis of 953 disciplinary actions from 2011-2018.
- Categorization by action type, profession, organizational factors, and location.
- Statistical analysis including frequencies, cross-tables, rates, and linear regression.
Main Results:
- Rural general practitioners received significantly more disciplinary actions than urban counterparts.
- Primary care physicians (GPs, private specialists) had higher action rates per 1000 doctors.
- Primary care doctors faced more warnings and license restrictions than secondary care doctors.
Conclusions:
- Disciplinary actions vary significantly by healthcare facility type in Norway.
- Rural general practitioners and private specialists are disproportionately affected.
- Further research is needed to understand malpractice factors and ensure supervisory efficiency.
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