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Regulatory complaint patterns in physical medicine and rehabilitation: A population-based cohort study
Nigel Ashworth1,2, Nicole Kain1,2, Homeira Hamayeli-Mehrabani2
1Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Background:
Regulatory complaints provide insight into physician performance and professionalism. Although complaint patterns have been described for the collective physician workforce, little is known about complaint risk among physical medicine and rehabilitation (PM&R) specialists (physiatrists).
Objective:
To examine the rate, type, and predictors of complaints among Alberta physiatrists and to compare complaint patterns across specialties.
Design:
Population-based cohort study using linked administrative data on physician demographics, practice characteristics, prescribing, and complaints.
Setting:
Province of Alberta, Canada; data from a provincial medical regulatory authority.
Participants:
All 11,315 physicians licensed in the province in 2025, including 114 physiatrists.
Interventions:
N/A.
Main Outcome Measures:
Presence of any nondismissed complaint (NDC), NDC rate per registration year, and distribution of complaint types.
Results:
Physiatrists had lower complaint rates than other physicians (10% vs. 21%). The mean NDC rate per registration year was 0.009 for physiatrists, less than half the rate observed among other physicians (0.021). Complaint rates were highest among surgical specialties and family medicine. The nature of complaints against physiatrists differed substantially from other specialties: practice management (48%) and medical reporting (19%) accounted for most complaints, whereas quality-of-care concerns predominated in other specialties. Increasing years since registration (odds ratio [OR] = 2.48, 95% confidence interval [CI] = 1.33-5.28) and international medical training (OR = 4.87, 95% CI = 1.15-20.99) were associated with higher odds of NDCs, although estimates were limited by small sample size.
Conclusions:
Although complaint rates were lower among physiatrists in this cohort, their complaints demonstrated a distinct pattern characterized by communication, documentation, and medicolegal interactions rather than clinical error. These findings highlight specialty-specific differences in regulatory complaints and suggest areas for targeted professional development in rehabilitation practice.