Outcomes of processes questioning a physician’s ability to practise —e.g. disciplinary or regulatory— may strongly impact their career and provided care. However, it is unclear what factors relate systematically to such outcomes. In this cross-sectional study, we investigate this via multivariate, step-wise, statistical modelling of all 1049 physicians referred for regulatory adjudication at the UK medical tribunal, from June 2012 to May 2017, within a population of 310,659. In order of increasing seriousness, outcomes were: no impairment (of ability to practise), impairment, suspension (of right to practise), or erasure (its loss). This gave adjusted odds ratios (OR) for: age, race, sex, whether physicians first qualified domestically or internationally, area of practice (e.g. GP, specialist), source of initial referral, allegation type, whether physicians attended their outcome hearing, and whether they were legally represented for it. There was no systematic association between the seriousness of outcomes and the age, race, sex, domestic/international qualification, or the area of practice of physicians (ORs p≥0.05), except for specialists who tended to receive outcomes milder than suspension or erasure. Crucially, an apparent relationship of outcomes to age (Kruskal-Wallis, p=0.009) or domestic/international qualification (χ2,p=0.014) disappeared once controlling for hearing attendance (ORs p≥0.05). Both non-attendance and lack of legal representation were consistently related to more serious outcomes (ORs [95% confidence intervals], 5.28 [3.89, 7.18] and 1.87 [1.34, 2.60], respectively, p<0.001). All else equal, personal characteristics or first qualification place were unrelated to the seriousness of regulatory outcomes in the UK. Instead, engagement (attendance and legal representation), allegation type, and referral source were importantly associated to outcomes. All this may generalize to other countries and professions.

中文翻译：

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参与而不是个人特征与对医生的监管裁决的严肃性有关：一项横断面研究

对医生的执业能力提出质疑的过程结果（例如，纪律或规章制度）可能会极大地影响其职业生涯并提供护理。但是，尚不清楚哪些因素与此类结果系统地相关。在这项横断面研究中，我们通过对2012年6月至2017年5月在英国医学法庭被推荐进行监管裁决的所有1049名医生进行多元，逐步，统计建模，在310,659名人群中进行调查。按照严重程度从高到低的顺序，结果是：无损害（具有执业能力），损害，中止（具有执业权）或消除（丧失执业权）。从而得出以下因素的调整后的优势比（OR）：年龄，种族，性别，是否首先获得国内或国际资格的医师，执业领域（例如，全科医生，专科医生），初次转诊的来源，指控类型，医生是否参加了结果听证会，以及是否有合法代表参加。结果的严重性与年龄，种族，性别，家庭/国际资格或医生的执业范围之间没有系统的关联（ORsp≥0.05），除了倾向于接受比暂停或擦除更轻的结果的专家外。至关重要的是，一旦控制了听觉出席率（ORs≥0.05），结果与年龄（Kruskal-Wallis，p = 0.009）或国内/国际资格（χ2，p = 0.014）之间的表观关系就消失了。缺勤和缺乏法律代理均与更严重的结果相关（OR [95％置信区间]，5.28 [3.89、7.18]和1.87 [1.34、2.60]，p <0.001）。其他都一样 个人特征或第一职业资格与英国监管结果的严重性无关。相反，参与（出席和法律代表），指控类型和推荐来源与结果密切相关。所有这些可能会推广到其他国家和行业。