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 þ 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
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.