Skip to main content
Top
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Characteristics and risk factors of pharmacist misconduct in New Zealand: a retrospective nationwide analysis

Authors: Yufeng Wang, Sanyogita (Sanya) Ram, Shane Scahill

Published in: BMC Health Services Research | Issue 1/2024

Login to get access

Abstract

Background

Professional misconduct has evolved into a worldwide concern, involving various forms and types of behaviours that contribute to unsafe practices. This study aimed to provide insights into the patterns characterising pharmacist misconduct and uncover underlying factors contributing to such instances in New Zealand.

Methods

This research examined all cases of pharmacist misconduct sourced from the Health Practitioners Disciplinary Tribunal (HPDT) database in New Zealand since 2004. Characteristics of the sampled pharmacists and cases were extracted, followed by a systematic coding of the observed misconduct issues. Identification of risk factors was accomplished through content analysis techniques, enabling an assessment of their prevalence across various forms of misconduct.

Results

The dataset of pharmacist misconduct cases comprised 58 disciplinary records involving 55 pharmacists. Seven types of misconduct were identified, with the most commonly observed being quality and safety issues related to drug, medication and care, as well as criminal conviction. A total of 13 risk factors were identified and systematically classified into three categories: (1) social, regulatory, and external environmental factors, (2) systematic, organisational, and practical considerations in the pharmacy, and (3) pharmacist individual factors. The most frequently mentioned and far-reaching factors include busyness, heavy workload or distraction; health impairment issues; and life stress or challenges.

Conclusions

The patterns of pharmacist misconduct are complicated, multifaceted, and involve complex interactions among risk factors. Collaborative efforts involving individual pharmacists, professional bodies, responsible authorities, policy-makers, health funders and planners in key areas such as pharmacist workload and well-being are expected to mitigate the occurrence of misconduct. Future research should seek to uncover the origins, manifestations, and underlying relationships of various contributing factors through empirical research with appropriate individuals.
Literature
1.
go back to reference Searle RH, Rice C. Making an impact in healthcare contexts: insights from a mixed-methods study of professional misconduct. Eur J Work Organ Psychol. 2021;30:470–81.CrossRef Searle RH, Rice C. Making an impact in healthcare contexts: insights from a mixed-methods study of professional misconduct. Eur J Work Organ Psychol. 2021;30:470–81.CrossRef
4.
go back to reference Sklar T, Taouk Y, Studdert D, Spittal M, Paterson R, Bismark M. Characteristics of lawyers who are subject to complaints and Misconduct findings. J Empir Leg Stud. 2019;16:318–42.CrossRef Sklar T, Taouk Y, Studdert D, Spittal M, Paterson R, Bismark M. Characteristics of lawyers who are subject to complaints and Misconduct findings. J Empir Leg Stud. 2019;16:318–42.CrossRef
5.
go back to reference Spittal MJ, Bismark MM, Studdert DM. The PRONE score: an algorithm for predicting doctors’ risks of formal patient complaints using routinely collected administrative data. BMJ Qual Saf. 2015;24:360–8.CrossRefPubMedPubMedCentral Spittal MJ, Bismark MM, Studdert DM. The PRONE score: an algorithm for predicting doctors’ risks of formal patient complaints using routinely collected administrative data. BMJ Qual Saf. 2015;24:360–8.CrossRefPubMedPubMedCentral
6.
go back to reference Spittal MJ, Bismark MM, Studdert DM. Identification of practitioners at high risk of complaints to health profession regulators. BMC Health Serv Res. 2019;19:380.CrossRefPubMedPubMedCentral Spittal MJ, Bismark MM, Studdert DM. Identification of practitioners at high risk of complaints to health profession regulators. BMC Health Serv Res. 2019;19:380.CrossRefPubMedPubMedCentral
7.
go back to reference Austin EE, Do V, Nullwala R, Fajardo Pulido D, Hibbert PD, Braithwaite J, et al. Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance. BMJ Open. 2021;11:e050377.CrossRefPubMedPubMedCentral Austin EE, Do V, Nullwala R, Fajardo Pulido D, Hibbert PD, Braithwaite J, et al. Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance. BMJ Open. 2021;11:e050377.CrossRefPubMedPubMedCentral
8.
go back to reference Bismark MM, Spittal MJ, Gurrin LC, Ward M, Studdert DM. Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia. BMJ Qual Saf. 2013;22:532–40.CrossRefPubMedPubMedCentral Bismark MM, Spittal MJ, Gurrin LC, Ward M, Studdert DM. Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia. BMJ Qual Saf. 2013;22:532–40.CrossRefPubMedPubMedCentral
9.
go back to reference Studdert DM, Bismark MM, Mello MM, Singh H, Spittal MJ. Prevalence and characteristics of Physicians Prone to Malpractice Claims. N Engl J Med. 2016;374:354–62.CrossRefPubMed Studdert DM, Bismark MM, Mello MM, Singh H, Spittal MJ. Prevalence and characteristics of Physicians Prone to Malpractice Claims. N Engl J Med. 2016;374:354–62.CrossRefPubMed
10.
go back to reference Croft E, Clark MT, Efstathiou N, Bradbury-Jones C. A focused mapping review and synthesis of a priori risk factors associated with medical misconduct. BMJ Open Qual. 2019;8:e000538.CrossRefPubMedPubMedCentral Croft E, Clark MT, Efstathiou N, Bradbury-Jones C. A focused mapping review and synthesis of a priori risk factors associated with medical misconduct. BMJ Open Qual. 2019;8:e000538.CrossRefPubMedPubMedCentral
11.
go back to reference Carlson JN, Foster KM, Pines JM, Corbit CK, Ward MJ, Hydari MZ, et al. Provider and practice factors associated with emergency physicians’ being named in a malpractice claim. Ann Emerg Med. 2018;71:157–164e4.CrossRefPubMed Carlson JN, Foster KM, Pines JM, Corbit CK, Ward MJ, Hydari MZ, et al. Provider and practice factors associated with emergency physicians’ being named in a malpractice claim. Ann Emerg Med. 2018;71:157–164e4.CrossRefPubMed
12.
go back to reference Guidera M, McCool W, Hanlon A, Schuiling K, Smith A. Midwives and liability: results from the 2009 nationwide survey of certified nurse-midwives and certified midwives in the United States. J Midwifery Womens Health. 2012;57:345–52.CrossRefPubMed Guidera M, McCool W, Hanlon A, Schuiling K, Smith A. Midwives and liability: results from the 2009 nationwide survey of certified nurse-midwives and certified midwives in the United States. J Midwifery Womens Health. 2012;57:345–52.CrossRefPubMed
13.
go back to reference Schaffer AC, Babayan A, Yu-Moe CW, Sato L, Einbinder JS. The effect of clinical volume on annual and per-patient encounter medical malpractice claims risk. J Patient Saf. 2021;17:e995–1000.CrossRefPubMed Schaffer AC, Babayan A, Yu-Moe CW, Sato L, Einbinder JS. The effect of clinical volume on annual and per-patient encounter medical malpractice claims risk. J Patient Saf. 2021;17:e995–1000.CrossRefPubMed
14.
go back to reference Millbank J. Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010-17. Aust Health Rev. 2020;44:190–9.CrossRefPubMed Millbank J. Serious misconduct of health professionals in disciplinary tribunals under the National Law 2010-17. Aust Health Rev. 2020;44:190–9.CrossRefPubMed
15.
go back to reference Surgenor LJ, Diesfeld K, Ip M, Kersey K. New Zealand’s health practitioners disciplinary Tribunal: an analysis of decisions 2004–2014. J Law Med. 2016;24:239–51.PubMed Surgenor LJ, Diesfeld K, Ip M, Kersey K. New Zealand’s health practitioners disciplinary Tribunal: an analysis of decisions 2004–2014. J Law Med. 2016;24:239–51.PubMed
16.
go back to reference Surgenor LJ, Diesfeld K, Kersey K, Kelly O, Rychert M. Fifteen years on: what patterns continue to emerge from New Zealand’s health practitioners disciplinary Tribunal? J Law Med. 2020;28:165–78.PubMed Surgenor LJ, Diesfeld K, Kersey K, Kelly O, Rychert M. Fifteen years on: what patterns continue to emerge from New Zealand’s health practitioners disciplinary Tribunal? J Law Med. 2020;28:165–78.PubMed
17.
go back to reference Elkin KJ, Spittal MJ, Elkin DJ, Studdert DM, Elkin KJ, Spittal MJ, et al. Doctors disciplined for professional misconduct in Australia and New Zealand, 2000–2009. Med J Aust. 2011;194:452–6.CrossRefPubMed Elkin KJ, Spittal MJ, Elkin DJ, Studdert DM, Elkin KJ, Spittal MJ, et al. Doctors disciplined for professional misconduct in Australia and New Zealand, 2000–2009. Med J Aust. 2011;194:452–6.CrossRefPubMed
18.
19.
20.
go back to reference Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8–14.CrossRef Bengtsson M. How to plan and perform a qualitative study using content analysis. NursingPlus Open. 2016;2:8–14.CrossRef
21.
go back to reference Källberg A-S, Göransson KE, Östergren J, Florin J, Ehrenberg A. Medical errors and complaints in emergency department care in Sweden as reported by care providers, healthcare staff, and patients– a national review. Eur J Emerg Med. 2013;20:33–8.CrossRefPubMed Källberg A-S, Göransson KE, Östergren J, Florin J, Ehrenberg A. Medical errors and complaints in emergency department care in Sweden as reported by care providers, healthcare staff, and patients– a national review. Eur J Emerg Med. 2013;20:33–8.CrossRefPubMed
22.
go back to reference Sparring Björkstén K, Bergqvist M, Andersén-Karlsson E, Benson L, Ulfvarson J, Björkstén KS. Medication errors as malpractice-a qualitative content analysis of 585 medication errors by nurses in Sweden. BMC Health Serv Res. 2016;16:1–8. Sparring Björkstén K, Bergqvist M, Andersén-Karlsson E, Benson L, Ulfvarson J, Björkstén KS. Medication errors as malpractice-a qualitative content analysis of 585 medication errors by nurses in Sweden. BMC Health Serv Res. 2016;16:1–8.
23.
go back to reference Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Dir Program Eval. 1986;30:73–84.CrossRef Lincoln YS, Guba EG. But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Dir Program Eval. 1986;30:73–84.CrossRef
24.
go back to reference Thomas DR. A General Inductive Approach for analyzing qualitative evaluation data. Am J Eval. 2006;27:237–46.CrossRef Thomas DR. A General Inductive Approach for analyzing qualitative evaluation data. Am J Eval. 2006;27:237–46.CrossRef
25.
go back to reference Jacobs S, Hassell K, Seston E, Potter H, Schafheutle E. Identifying and managing performance concerns in community pharmacists in the UK. J Health Serv Res Policy. 2013;18:144–50.CrossRefPubMed Jacobs S, Hassell K, Seston E, Potter H, Schafheutle E. Identifying and managing performance concerns in community pharmacists in the UK. J Health Serv Res Policy. 2013;18:144–50.CrossRefPubMed
26.
go back to reference Walton M, Kelly PJ, Chiarella EM, Carney T, Bennett B, Nagy M, et al. Profile of the most common complaints for five health professions in Australia. Aust Health Rev. 2020;44:15–23.CrossRefPubMed Walton M, Kelly PJ, Chiarella EM, Carney T, Bennett B, Nagy M, et al. Profile of the most common complaints for five health professions in Australia. Aust Health Rev. 2020;44:15–23.CrossRefPubMed
27.
go back to reference Surgenor L, Diesfeld K, Rychert M, Kelly O, Kersey K. Criminal Convictions of Disciplined Health Practitioners in New Zealand. J Law Med. 2022;29:117–28.PubMed Surgenor L, Diesfeld K, Rychert M, Kelly O, Kersey K. Criminal Convictions of Disciplined Health Practitioners in New Zealand. J Law Med. 2022;29:117–28.PubMed
28.
go back to reference Peerally MF, Carr S, Waring J, Martin G, Dixon-Woods M. A content analysis of contributory factors reported in serious incident investigation reports in hospital care. Clin Med. 2022;22:423–33.CrossRef Peerally MF, Carr S, Waring J, Martin G, Dixon-Woods M. A content analysis of contributory factors reported in serious incident investigation reports in hospital care. Clin Med. 2022;22:423–33.CrossRef
29.
go back to reference Saqib A, Atif M, Ikram R, Riaz F, Abubakar M, Scahill S. Factors affecting patients’ knowledge about dispensed medicines: a qualitative study of healthcare professionals and patients in Pakistan. PLoS ONE. 2018;13:e0197482.CrossRefPubMedPubMedCentral Saqib A, Atif M, Ikram R, Riaz F, Abubakar M, Scahill S. Factors affecting patients’ knowledge about dispensed medicines: a qualitative study of healthcare professionals and patients in Pakistan. PLoS ONE. 2018;13:e0197482.CrossRefPubMedPubMedCentral
30.
go back to reference Searle RH, Rice C, McConnell AA, Dawson JF. Bad apples? Bad barrels? Or bad cellars? Antecedents and processes of professional misconduct in UK Health and Social Care: Insights into sexual misconduct and dishonesty. 2017. Searle RH, Rice C, McConnell AA, Dawson JF. Bad apples? Bad barrels? Or bad cellars? Antecedents and processes of professional misconduct in UK Health and Social Care: Insights into sexual misconduct and dishonesty. 2017.
31.
go back to reference Pereira-Lima K, Mata DA, Loureiro SR, Crippa JA, Bolsoni LM, Sen S. Association between physician depressive symptoms and medical errors: a systematic review and meta-analysis. JAMA Netw Open. 2019;2:e1916097.CrossRefPubMedPubMedCentral Pereira-Lima K, Mata DA, Loureiro SR, Crippa JA, Bolsoni LM, Sen S. Association between physician depressive symptoms and medical errors: a systematic review and meta-analysis. JAMA Netw Open. 2019;2:e1916097.CrossRefPubMedPubMedCentral
32.
go back to reference Brown SD, Goske MJ, Johnson CM. Beyond substance abuse: stress, Burnout, and Depression as causes of Physician Impairment and disruptive behavior. J Am Coll Radiol. 2009;6:479–85.CrossRefPubMed Brown SD, Goske MJ, Johnson CM. Beyond substance abuse: stress, Burnout, and Depression as causes of Physician Impairment and disruptive behavior. J Am Coll Radiol. 2009;6:479–85.CrossRefPubMed
33.
go back to reference Bradfield OM, Bismark M, Scott A, Spittal M. Vocational and psychosocial predictors of medical negligence claims among Australian doctors: a prospective cohort analysis of the MABEL survey. BMJ Open. 2022;12:e055432.CrossRefPubMedPubMedCentral Bradfield OM, Bismark M, Scott A, Spittal M. Vocational and psychosocial predictors of medical negligence claims among Australian doctors: a prospective cohort analysis of the MABEL survey. BMJ Open. 2022;12:e055432.CrossRefPubMedPubMedCentral
34.
go back to reference Kenna GA, Wood MD. Prevalence of substance use by pharmacists and other health professionals. J Am Pharm Assoc. 2004;44:684–93.CrossRef Kenna GA, Wood MD. Prevalence of substance use by pharmacists and other health professionals. J Am Pharm Assoc. 2004;44:684–93.CrossRef
35.
go back to reference Surgenor LJ, Diesfeld K, Kersey K, Ip M. Practitioner health issues featuring before New Zealand’s health practitioners disciplinary Tribunal: an analysis of cases 2003–2014. J Law Med. 2017;24:590–6.PubMed Surgenor LJ, Diesfeld K, Kersey K, Ip M. Practitioner health issues featuring before New Zealand’s health practitioners disciplinary Tribunal: an analysis of cases 2003–2014. J Law Med. 2017;24:590–6.PubMed
37.
go back to reference Lianov L. A powerful antidote to physician burnout: intensive healthy lifestyle and positive psychology approaches. Am J Lifestyle Med. 2021;15:563–6.CrossRefPubMedPubMedCentral Lianov L. A powerful antidote to physician burnout: intensive healthy lifestyle and positive psychology approaches. Am J Lifestyle Med. 2021;15:563–6.CrossRefPubMedPubMedCentral
38.
go back to reference Bradfield O, Jenkins K, Spittal M, Bismark M. Australian and New Zealand doctors’ experiences of disciplinary notifications, investigations, proceedings and interventions relating to alleged mental health impairment: a qualitative analysis of interviews. Int J Law Psychiatry. 2023;86:101857. Bradfield O, Jenkins K, Spittal M, Bismark M. Australian and New Zealand doctors’ experiences of disciplinary notifications, investigations, proceedings and interventions relating to alleged mental health impairment: a qualitative analysis of interviews. Int J Law Psychiatry. 2023;86:101857.
39.
go back to reference Bradfield OM, Bismark MM, Spittal MJ, O’Brien P. The publication of impaired doctors’ identity by Australian and New Zealand tribunals: law, practice, and reform. Med Law Rev. 2023;31:391–423.CrossRefPubMedPubMedCentral Bradfield OM, Bismark MM, Spittal MJ, O’Brien P. The publication of impaired doctors’ identity by Australian and New Zealand tribunals: law, practice, and reform. Med Law Rev. 2023;31:391–423.CrossRefPubMedPubMedCentral
40.
go back to reference Wexler DB, Winick BJ. Law in a therapeutic key: developments in therapeutic jurisprudence. Curr Issues Crim Justice. 1997;8:337–40.CrossRef Wexler DB, Winick BJ. Law in a therapeutic key: developments in therapeutic jurisprudence. Curr Issues Crim Justice. 1997;8:337–40.CrossRef
41.
go back to reference Wang Y, Ram S, Scahill S. Risk identification and prediction of complaints and misconduct against health practitioners: a scoping review. Int J Qual Health Care. 2024;36:mzad114. Wang Y, Ram S, Scahill S. Risk identification and prediction of complaints and misconduct against health practitioners: a scoping review. Int J Qual Health Care. 2024;36:mzad114.
Metadata
Title
Characteristics and risk factors of pharmacist misconduct in New Zealand: a retrospective nationwide analysis
Authors
Yufeng Wang
Sanyogita (Sanya) Ram
Shane Scahill
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10591-2

Other articles of this Issue 1/2024

BMC Health Services Research 1/2024 Go to the issue