Sex differences in medico-legal action against doctors: a systematic review and meta-analysis - PubMed (original) (raw)

Review

Emily Unwin et al. BMC Med. 2015.

Abstract

Background: The relationship between male sex and poor performance in doctors remains unclear, with high profile studies showing conflicting results. Nevertheless, it is an important first step towards understanding the causes of poor performance in doctors. This article aims to establish the robustness of the association between male sex and poor performance in doctors, internationally and over time.

Methods: The electronic databases MEDLINE, EMBASE, and PsycINFO were searched from inception to January 2015. Backward and forward citation searching was performed. Journals that yielded the majority of the eligible articles and journals in the medical education field were electronically searched, along with the conference and poster abstracts from two of the largest international medical education conferences. Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors' sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation.

Results: Overall, 32 reports examining the association between doctors' sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses.

Conclusion: Male doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time.

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Figures

Fig. 1

Fig. 1

Flow chart showing reports retrieved, and articles excluded and included in the review based on the PRISMA Statement [10]

Fig. 2

Fig. 2

Results of meta-analysis of 19 reports on the association between doctor’s sex and experience of medico-legal action using both fixed-effects and random-effects modelling

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References

    1. General Medical Council. The state of medical education and practice in the UK. London: GMC; 2014.
    1. Federation of State Medical Boards. U.S. Medical Regulatory Trends and Actions.Federation of State Medical Boards; 2014.
    1. Dyer C. GMC and vulnerable doctors: too blunt an instrument? BMJ. 2013;347:f6230. doi: 10.1136/bmj.f6230. - DOI - PubMed
    1. Archer J, Regan de Bere S, Bryce M, Nunn S, Lynn N, Coombes L, et al. Understanding the rise in Fitness to Practise complaints from members of the public. Plymouth: Plymouth University; 2014.
    1. Unwin E, Woolf K, Wadlow C, Dacre J. Disciplined doctors: does the sex of a doctor matter? A cross-sectional study examining the association between a doctor’s sex and receiving sanctions against their medical registration. BMJ Open. 2014;4 doi: 10.1136/bmjopen-2014-005405. - DOI - PMC - PubMed

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