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The impact of patient complaints and compliments on medical performance: a systematic review

Rebecca Baines, Tristan Price, Julian Archer, Marie Bryce


Background: Patient complaints and compliments are considered integral to patient safety and quality of care. This review therefore sought to explore the impact of patient complaints and compliments on the medical performance of individual doctors.

Method: Database searches were performed in PubMed, PsycInfo, EMBASE, Medline, CINAHL and the Cochrane Library for peer-reviewed publications published in the English language between 2007-2017. Data were thematically analysed and synthesised using a modified narrative approach. Impact was assessed using Barr’s (2000) adaptation of Kirkpatrick’s evaluation model.

Results: Of the 355 articles retrieved, 6 were included. One identified a change in measured performance (Kirkpatrick level 3b). Five identified a self-reported change (Kirkpatrick level 3a) in performance  or behaviour. No articles identified a change in the health and wellbeing of patients (Kirkpatrick level 4). Improved patient relations, more thorough documentation, enhanced referral, prescription and testing requests were identified as positive impacts, although such changes may also be detrimental. Other detrimental impacts identified included a break down in patient relations, increased defensive practise, early retirement and altered physical or mental wellbeing. Personal, procedural and cultural factors appeared influential. No articles examining the impact of compliments were identified.

Conclusion: Patient complaints can have an impact on medical performance. These can be both positive and negative. The intended purpose of complaints may be undermined by personal, procedural and cultural factors. The fear, language and stigmatisation of complaints should be addressed and the recognition of compliments more actively encouraged. Review findings have implications for those involved in designing and supporting complaint and compliment processes within the broader framework of person-centered care approaches in health systems.


Avoidance behaviour, compliments, defensive practice, medical performance, patient complaints, patient safety, person-centered healthcare, psychological impact, review, quality of care

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