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Abstract
Introduction Disciplinary procedures can have serious consequences for the health, personal life and professional functioning of doctors. Until recently, specific disciplinary measures (reprimands) were publicly disclosed in the Netherlands. The perceived additional impact of disclosing reprimands on the professional and personal life of doctors is unclear.
Methods All doctors who received a disciplinary measure from the Dutch Disciplinary Board between July 2012 and August 2016 were invited to partake in a 60-item questionnaire concerning the respondents’ characteristics, the complaint, experience with the procedure and perceived impact of the procedure on health and professional functioning as reported by doctors themselves. The response rate was 43% (n=210). 21.4% received a reprimand (disclosed); the remainder received a warning (not disclosed). Differences between the two groups were calculated.
Results Respondents with a reprimand reported significantly more negative experiences and impact on health and work than respondents with a warning. 37.8% of the doctors said their health was very good. A small percentage reported moderate-to-severe depressive complaints (3.6%), moderate-to-severe anxiety disorder (2%) or indications of burnout (10.8%). The majority reported changes in their professional practices associated with ‘defensive medicine’, such as doing more supplementary research (41%) and complying more with patients’ wishes (35%).
Conclusion The Dutch disciplinary procedure has strong negative side effects, that disclosing measures seems to increase. Dutch disciplinary law aims to contribute to the quality of professional practice. A safe environment is a basic condition for quality improvement and therefore, disclosure of disciplinary measures should be carefully considered. Disclosure of disciplinary measures has always been controversial and the results of this study has rekindled this debate. Recently, a majority in the Dutch House of Representatives has voted against disclosure of reprimands, leaving disclosure of reprimands a discretion of the disciplinary board when deemed appropriate or necessary.
- quality in health care
- risk management
- medical law
- health policy
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Footnotes
Contributors BL, RB, AJEdV and RF participated in the design of the study. RB and MH analysed and interpreted the data. All authors helped to draft the manuscript. All authors critically revised and approved the final manuscript. All authors agreed to be personally accountable for the author’s own contributions and for ensuring that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved and documented in the literature.
Funding This study was funded by the Dutch Ministry of Health, Welfare and Sports.
Competing interests None declared.
Ethics approval As all the research participants were competent individuals and no participants were subjected to any interventions or actions, no ethical approval was needed under Dutch law on medical research (Medical Research Involving Human Subjects Act).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Extra data are available by emailing RB: r.bouwman@nivel.nl.
Patient consent for publication Not required.