• General practice
• Incident reporting
• Patient satisfaction

In reply: Obermair, Janda and Gebski question our broad conclusion, based on a study of 19 000 healthcare complaints against Australian doctors over a decade, that it is feasible to predict which doctors are at high risk of recurrent complaints. Specifically, they assert that our approach is an ‘oversimplification’ that does not include doctors with no complaints and does not take account of patient volume or other aspects of the doctor–patient relationship.

Our study adopted a regulator's perspective: we sought to understand what health complaints commissioners, medical boards and liability insurers might do with the detailed information they gather on cases, above and beyond their usual business of processing complaints and claims. We explored what potential these data had to guide quality-improvement efforts. Given this perspective, doctors who were complained against at least once are the appropriate focus; these doctors are visible to regulators, there is a natural point of contact through the complaints process, and that process may include opportunities to prevent future events, …