Surgeons attract more than twice as many complaints about their practice than physicians, according to an analysis of six years’ worth of data from Australian medical regulators.

But the higher rate is not wholly explained by the theory it’s because surgeons practice the riskiest type of medicine, according to the authors of the study.

The researchers analysed over 5500 complaints – the majority made by patients – lodged with regulators in the six years to December 2016, broken down into categories of ‘treatment and procedure’, ‘other performance’, ‘professional conduct’ and ‘health’.

They found the rate of complaints was 2.3 times higher for specialists in adult and paediatric surgery (3671 complaints) than for specialists in internal medicine (1917).

“Some surgeons have speculated that this arises from the procedural nature of their work – particularly its level of risk and the immediate and overt nature of outcomes,” wrote the authors in the ANZ Journal of  Surgery.

“A competing explanation is that behaviours that provoke medicolegal actions (eg poor communication skills) are much more prevalent among surgeons – either because persons with such traits select surgery or because these traits develop during training and practice.”

The analysis found surgeons had 10 times more complaints about procedures than physicians – accounting for three-fifths of the risk difference.

But they also had more than 1.5 times more complaints about monitoring and follow up, fees and fraud, reports and certificates, substance use, communication and interpersonal behaviour.

“Recent research into discrimination and bullying in the surgical profession found that these behaviours are ‘pervasive and serious problems in the practice of surgery’. Our findings bolster these concerns,” the authors wrote.

“Previous studies have shown worrying levels of alcohol misuse and burnout among surgeons. This study found that while health related complaints were rare, surgeons were significantly more likely to be the subject of a complaint about substance use.”

The study found 6 % of surgeons accounted for 42% of complaints against their cohort, with men aged over 65 working in neurosurgery, plastic surgery and orthopaedic surgery at the highest risk.

However, physicians had a higher rate of complaints about prescribing than surgeons.