Four decades of complaints to a State Medical Board about graduates from one medical school: implications for change in self-regulation processes.

In the context of the impending national registration of health practitioners in Australia including doctors, this column describes the types and patterns of complaints to a State Medical Board across an extended period, about graduates from one medical school. De-identified data concerning complaints about medical practitioners who had graduated from the University of Queensland, made to the Medical Board of Queensland between 1968 and 2006, were analysed. The main outcome measures were category of complaint, total complaint rate per doctor-year, frequency of complaints per practitioner and outcomes of complaints. There were 12 categories of complaints, encompassing different aspects of clinical management, impairment and unethical conduct. Outcomes included "no further action", a hierarchy of recommendations and conditions on registration, suspension, deregistration, health assessment, or referral to alternative bodies. Complaints predominantly related to clinical standards, and this also applied to those who attracted multiple complaints. Most cases were managed without resort to sanctions of any kind. Sanctions may be underutilised, particularly in cases of apparent recalcitrance. Improved tracking and appropriate reeducation and disciplinary measures will assist in better protecting the public under the new national registration arrangements.