The determinants of professional incompetence: an analysis of medical errors from the intellectual capital perspective

According to an estimation from the Institute of Medicine (IOM) (1999), 44,000 to 98,000 people died from medical errors in the USA. Medical errors are considered as the most important quality-related performance indicator for both healthcare organisations and professionals. This study applied the analytical framework of intellectual capital by Edvinsson and Malone (1997) to explore the factors associated with professional incompetence with a sample of 407 Taiwanese surgeons. Intellectual capital has been proposed to capture the intangible aspect of organisational process. We proposed that doctors' professional incompetence cannot be considered as individual-level attributes, but should be examined as the results determined by multiple interactions among human, social and organisational capital. The results of the study revealed that among all the types of medical errors reported by surgeons, the types that occur most often are misdiagnosis and delay diagnosis. Higher professional training is more likely to reduce the incidence of adverse surgical errors. Organisational capital, including establishing a formal reporting procedure, feedback mechanisms and the reduction of interruptions during surgery, can all reduce the reported surgical errors. Surgeons who frequently change their practicing organisations are less likely to accumulate hospital-specific experiences, which are needed for effective surgical teamwork, and are consequently more likely to have surgical errors. Professional incompetence, measured by medical errors, can reflect the multiple interactions between different components of intellectual capital in healthcare organisations.