Interdisciplinary Health Research Group

Complaints Against Doctors and Nurses: A Study of the Impact of Ideological and Structural Changes

This research project emerges from a pilot study on complaints and disciplinary action against nurses in Ontario. The research is exploring the process of complaints against health professionals, specifically nurses and doctors, and how this process relates to structural changes in health care and ideological changes (e.g. individualism and consumerism) in society.

The work done thusfar has shown an increase in complaints against nurses during the period 1983 to 1993, and a concomitant increase in disciplinary actions carried out by the regulatory body, the College of Nurses. Not only was there an increase in complaints but there was also a change in the relative significance of sources of complaints less from employers, supervisors and colleagues, more from the general public. Such changing patterns may provide important insights into the linkages between ideological and structural changes within the health care system.

The study will provide information on the nature of complaints and the complaint/disciplinary action processes from the vantage point of regulators, employers, unions, consumers and individual practitioners. It is expected to demonstrate the possible unintended consequences of structural change, and to provide a commentary on the relations between ideology of individualism and individual rights, the emergence of a climate of complaining, and health care practice.

These links to be explored by :

    1. documenting, from 1980 or as long as records allow, the changing nature of complaints and disciplinary action against selected health care professionals, and in particular nurses (largely completed) and physicians;

    2. carrying out key informant interviews with representatives of the professional colleges, to discuss the nature of complaints and disciplinary action, to understand the changing nature of health care work by various professions, including medicine, and to explore linkages between these issues and broader societal processes

    3. conducting in-depth interviews with selected respondents from collateral organizations, such as professional associations and consumer groups, in order to gauge the nature and level of complaints against nurses and physicians, as well as discontents which may not reach the regulatory bodies;

Persons to be interviewed include members of regulatory bodies in Ontario (College of Nurses, College of Physicians and Surgeons, Health Professions Board), various unions (e.g., CUPE, OPSEU, ONA) and professional bodies (e.g., Registered Nurses' Association, Registered Practical Nurses' Association, Ontario Medical Association), organizations (patient and consumer rights), employers (hospitals, nursing homes), and individuals who have been subject to complaints and action.

In addition to archival data and interviews, government documents and media sources will also be used to collect information. Collaboration with researchers in Britain will allow us to make international comparisons, and to understand more fully the significance of ideological and structural changes in the health care professions in the Ontario context.

This research project has been funded by the Social Sciences and Humanities Research Council.