Doctors' 'Bedside Manner Test' Predicts Patient Complaints

Tamblyn's team followed 3,424 physicians licensed to practice in Ontario and Quebec who took the Medical Council of Canada clinical skills examination between 1993 and 1996. They discovered a very strong relationship between those who scored poorly and later complaints by patients.

"Low scores on the exam were quite predictive," said Tamblyn, scientific director of McGill University's Clinical and Health Informatics research unit. "It was really like a dose-response relationship. The higher your score, the less likely you would get complaints. And this was whether you were a man, a woman, a foreign medical graduate or whether you were in Ontario or Quebec. It was amazingly robust."

The Medical Council of Canada became the first accreditation body in the world to introduce patient-physician communication skills testing as part of the medical credentialing process in the 1990's. Despite generating considerable controversy at the time, the study's results prove their value, said Tamblyn. "This is a bit of a good news story for Canada. We led the world in this." The United States instituted similar testing in 2005, and Tamblyn expects to see similar results there.

There were 1,116 complaints filed for 3,424 physicians, of which 696 were retained by the regulatory bodies after investigation. Physicians who scored in the lowest 25 percent of all those tested were disproportionately likely to generate complaints, according to the study, adding up to 170 complaints above what would be expected statistically annually.

"The good news is that this type of testing could be done much earlier and we could make things better for all physicians and patients." said Tamblyn. "We could even make it part of the admissions procedures to medical school. We need to have physicians who can communicate better, and we should select not just on the basis of IQ, but of emotional IQ."

Reference: JAMA. 2007;298(9):993-1001.