Examining the file of complaints received by the organization of the medical system of Mashhad from the dentists in the years 1380-1390

Dissertation for obtaining a doctorate degree in dentistry

Abstract:

Introduction and purpose: One of the most important job tensions that dentists may face in their profession is patient complaints. The purpose of this study is to present a picture of dental malpractices in Mashhad city. Materials and methods: The file of complaints received by the Mashhad Medical System Organization from dentists in the years 80-90, in which the dentist's culpability or not, was investigated. The variables of the place of treatment, occupation of the service provider, gender of the patient and the dentist, the dental treatment performed, the cause of the complaint and the complication of the treatment were investigated. Data analysis was done by spss15 software and using descriptive statistics and chi-square test. Findings: Among 250 complaint cases, in 62.4% of the cases, a verdict was issued against dentists' negligence. Most of the dentists who were sued were male. The frequency of complaints was related to general dentists (87.2%), endodontic specialists (4.4%) and finally periodontology specialists (0.4%). The highest frequency of malpractice was related to private offices (62.8%), private dental clinics (28.4%), charity clinics (3.2%) and finally hospital clinics (2.8%). The highest frequency of treatment complications was related to the loss of teeth by general dentists.

Conclusion: If the dentist has a proper interaction with the patient and performs treatments that he can afford in terms of scientific and practical ability, it can be expected that dental malpractices will decrease.

Chapter One:

review of texts and articles

1-1 Introduction

commensurate with the society's respect and honor towards doctors, their professional responsibility and obligations are also prominent, in other words, when a person is proud to wear a medical gown, the society considers itself obliged to protect his dignity and he He also sees himself as obliged to comply with certain rules in society.

One ??of the most important job tensions that any doctor can face in his profession is patient complaints. When a doctor finds himself facing a legal complaint from a patient, he feels shaken in all the above beliefs and infrastructures and sees his social dignity at risk. This causes anxiety, tension, depression, isolation and even illness (1). This tension is not only limited to cases where the doctor is at fault, but even when the patient's complaint is due to his misunderstanding or bad intentions, the doctor will have to endure unfavorable conditions. Therefore, every complaint past the time he receives from the doctor causes significant psychological stress for him and a direct negative impact on his work.

On the other hand, studies have shown that the increase in the number of complaints in some medical specialties reduces the willingness of candidates to enter these fields on the one hand and reduces the risk of accepting procedures with a higher risk-taking and, naturally, the probability of complaints is higher (1,2).

Anyway, nowadays complaints The doctor is considered as one of the most important stress factors in the medical profession, and not paying attention to its occurrence factors has both adverse effects on the quality of services provided by the doctor and indirectly affects the health system. Identifying the effective factors in the occurrence of complaints and its process can be used in the prevention and education of various medical professions.

The purpose of this study is to investigate the course and frequency of complaints received by the medical system organization of Mashhad from the dentists in 1380-1390 in terms of the cause of the complaint, the type of treatment provided, the complications of the treatment, the age and gender of the dentist and the patient, the place of the accident, the fault or not of the person providing the service and the occupation of the person providing the service.

1-2 Generalities

1-2-1 Laws:

Laws are the set of regulations that govern the people of a society at a given time.Humans are social by nature and in order to meet their emotional and material needs, they have to socialize with their fellow humans. As far as history remembers, human beings have lived together and society and individual have been necessary and necessary for each other. On the other hand, people's desires are similar to each other, and therefore, anger, strife, and enmity take place to attract more benefits and provide a better life. In the same sense, it has been recognized that in order to preserve and survive the society, there must be rules governing the relations of individuals, which are called "rights".

Another meaning of rights has been defined as "the sum of rights" and it is a special right, privilege and ability that the law assigns to an individual or individuals, such as the right to property and the right to alimony (3).

What is important is that the legal rules Three principles are followed, including:

1 - The legal rule is one of the social phenomena and it is for the survival and durability of society.

2- The legal rule is binding and must be followed in order to create order.

3- Its implementation must be guaranteed and supported by the government.

Laws are of two categories: 1. Public 2. Private.

Public law deals with the relations of the government and government officials with people and government organizations and their support. Private law is the rules that govern the relationships of individuals, such as the rules that govern business and family relationships (3).

Considering the above issues, it can be said that the relationship between doctor and patient is also subject to the laws of public law, the rules of which are determined by the government (3).

In medical criminal law, medical crimes that violate medical and pharmaceutical laws and regulations and cause the disruption of order and security in society and the responsibility of the perpetrators. brought, is studied.

In penal law, the basis of criminal liability is based on the crime and the mistake of the perpetrator, and criminal actions resulting from human actions and omissions are called crimes. With the establishment of the Islamic Penal Code in 1361, the legislator has divided crimes into five categories according to their type, which are: 1 - punishment 2 - retribution 3 - diet 4 - penance 5 - deterrent punishments

criminal phenomenon or criminal acts caused by the act or Except in the case of murder, the omission of human action may appear in two ways.

1- Intentional crimes: It refers to crimes that the perpetrator commits with free will and with a definite and known intention and having consciousness. In other words, the perpetrator must have intent in committing these crimes, and in order to realize the intent, it must be proven that:

a) Did the perpetrator have the power and intelligence to discern or not?

b) Did he do the act willingly or not?

c) Did he do the act out of malice and with the intention of obtaining a criminal result or not?

If the answer to all three questions is positive, the action can be called intentional.

2 - Unintentional crimes: It refers to those crimes whose spiritual element is made up of criminal wrongdoing, not intentionality and malice.

According to the above definition, the existence of a criminal wrongdoing is necessary for non-intentional crimes, and only committing a material act is not enough to punish someone exposed to responsibility and punishment, and he must have committed a mistake in this act, such as carelessness, impudence, lack of skill, or non-compliance with government systems, in order to deserve punishment. Some jurists have mentioned complacency, negligence, neglect, negligence, fault, failure to comply with government systems, imprudence, impudence, and lack of skill as examples of criminal wrongdoing (4). duty.

2 - Violation of medical and pharmaceutical laws and regulations.

3 - Disciplinary violations by doctors and related professions.

4 - Unauthorized intervention of unqualified people in medical and pharmaceutical affairs.