Canadian doctors who score poorly on "bedside manner" tests are far more likely to be the subject of patient complaints to regulatory authorities, finds a new study from McGill University researchers.

A team led by Robyn Tamblyn of McGill's Clinical and Health Informatics research unit looked at 3,424 physicians licensed to practice in Ontario and Quebec who took the Medical Council of Canada's clinical skills examination, between 1993 and 1996.

They discovered a strong relationship between those physicians who scored poorly on the test and the likelihood that patients would file later complaints against those doctors.

The researchers found that 1,116 complaints were filed for the 3,424 physicians; 696 complaints were retained after investigation.

The majority of retained complaints (81.9 per cent) were for attitude/communication and quality-of-care problems.

Communication problems and inappropriate treatment/follow-up were the most common causes of quality-of-care complaints. Examples of communication that would receive a low score include doctors who show condescending, offensive, or judgmental behaviours, or those who ignore patient responses during office visits.

Physicians who scored in the lowest 25 per cent of those tested in the clinical skills examination were most likely to generate complaints, adding up to 170 complaints above what would be expected statistically annually.

"Low scores on the exam were quite predictive. The higher your score, the less likely you would get complaints," said Tamblyn.

"And this was whether you were a man, a woman, a foreign medical graduate or whether you were in Ontario or Quebec. It was amazingly robust."

The study is published in JAMA, the Journal of the American Medical Association

The Medical Council of Canada became the first accreditation body in the world to introduce patient-physician communication skills testing as part of the medical credentialing process in the 1990's. Despite generating considerable controversy at the time, Tamblyn says the results of her study prove that the skills are crucial to a doctor's success.

She suggests that such testing could be done even earlier.

"We could even make it part of the admissions procedures to medical school," she suggests.

"We need to have physicians who can communicate better, and we should select not just on the basis of IQ, but of emotional IQ."