Volume 7 • 2020 • Issue 7

It’s not just about treatment, it’s about how patients are treated throughout their care experience. Researchers from the University of Toronto (U of T) examined, coded, quantified and analyzed complaints made to the Royal College of Dental Surgeons of Ontario (RCDSO) between 2007 and 2017. What CanLetters of Complaint to aDental College TeachUs? D uring the two-year study 1 , 2,199 letters— from a total of 4,627—were read and coded for the complaints they contained. “The letters of complaint can be thought of like individual stories,” says Monika Roerig, a research associate and a lead organizer of the study. “Like all stories, they are subject to different interpretations and meanings, which is why establishing and testing our taxonomy, or coding framework, was an extensive and critical aspect of this project. While there were commonalities in terms of the issues raised, each complainant had a unique way of expressing their grievance through text.” Letters of complaint are complex and often include more than one kind of problem. The letters, most often, describe service failures or unmet expectations, and thus the researchers saw that they had potential to provide useful and actionable feedback for dentists, dental educators and organized dentistry at-large. According to a report on the analysis available from the RCDSO, “considering the complainant’s perspective is especially important for gaining insight about expectations and areas requiring improvement.” The researchers designed their coding framework to account for how complainants evaluate service quality, including clinical components, safety, administration of dental offices, interpersonal skills of providers and access to care. “Analyzing almost 2,200 letters of complaint was a full team effort that required extensive coordination,” says Roerig. Dr. Carlos Quiñonez, associate professor in the U of T Faculty of Dentistry and lead researcher, says the study is the first time an analysis of this kind has been undertaken in Canada. “As well, it is the first internationally, from what we know, to use such a large sample of patient complaints,” he says. “The coding taxonomy that we developed to code the letters of complaint is itself novel, as is focusing on the complainant’s perspective as primary.” The study: The sample: Letters of Complaint N ews and E vents