Patient complaints differ for male and female obstetrician-gynecologists: an exploration of 20 years of complaints data in Alberta, Canada.

BACKGROUND: Patient complaints are valuable indicators of systemic issues in healthcare, offering opportunities to enhance care quality and safety. Obstetrics and gynecology (OBGYN) is a specialty particularly prone to complaints, reflecting its unique challenges related to patient population, sensitive subject matter, and physician-patient dynamics. The impact of physician sex on patient complaints is not well understood, particularly taking into context the changing demographics of the OBGYN workforce. METHODS: A longitudinal cohort of all obstetrician-gynecologists registered with the College of Physicians & Surgeons of Alberta (CPSA) between 2003 to 2024 linked to the CPSA Complaints database was used. Quantitative analysis included comparisons of mean and proportion, logistic regression, Kaplan-Meier survival, and Cox regression analyses to assess associations between physician characteristics and complaints. Adjusted models accounted for physician sex, birth year, and training location, measured using the Transparency International Corruption Perceptions Index as a proxy for healthcare system similarity to Canada. Content analysis categorized the anonymized complaint narratives provided insights themes of grievances. RESULTS: The cohort included 449 OBGYN physicians (59.2% female, 40.8% male). Overall, 44.8% of physicians experienced at least one complaint during the study period. Male physicians were more likely to receive complaints than female physicians (52.5% vs. 39.5%), with higher adjusted odds of ethics-related complaints (aOR 2.16, 95% CI 1.12-4.16). Adjusted analyses revealed no significant differences in overall complaint frequency or time to first complaint between male and female OBGYNs. Content analysis highlighted recurring themes of communication, professionalism, and patient-centered care. CONCLUSION: While crude analyses suggested sex-based differences in complaint patterns, these associations were attenuated after adjusting for physician age and training location, indicating that the total effect of sex on complaints may be mediated by these factors. However, male physicians remained more likely to receive ethics-related complaints even after adjustment, suggesting a possible direct association. These findings emphasize the need for targeted professional development focused on culturally sensitive communication and patient rapport and underscore the need to consider sex and gender dynamics in OBGYN to promote equity and improve patient care. Future research should explore systemic and structural contributors to complaint patterns across broader geographic and clinical contexts.