Objective: To gain insight into disciplinary proceedings for healthcare practitioners in the Netherlands.
Design: Descriptive, retrospective study.
Method: We examined all first verdicts pronounced by disciplinary boards during the period 1983-2002 involving physicians, dentists, pharmacists and midwifes. The following information was studied: year of the verdict, number and nature of complaints, plaintiff characteristics, types ofpractitioners accused, verdicts and number ofcases appealed and their outcomes.
Results: Disciplinary boards addressed 13,228 complaints during the study period (average 661 per year). The number of complaints increased more rapidly than the number of practitioners. Most complaints concerned physicians (92%). The complaint density was highest for physicians; it was higher for general practitioners than specialists and generally higher for surgical specialists than non-surgical specialists. Half of the complaints concerned 'lack of care or inadequate care' or 'incorrect treatment'. The number of complaints that resulted in sanctions decreased during the study period (average 18%). The sanction density remained constant throughout the study period (0.25 sanctions per 100 practitioners). The sanction density was highest for physicians and higher for general practitioners than for specialists. Overall, 45 practitioners were permanently struck from the register or had their licence to practice revoked.
Conclusion: There was a slight increase in the number ofcomplaints over the past 20 years. The corrective effects of the disciplinary code are obvious from the number of individuals who were permanently struck from the register or had their license to practice revoked. An increased impact on the quality of care should be sought through prevention and education. Disciplinary jurisprudence warrants more attention in training and continuing educational courses. Publishing verdicts may also increase attention.