Thursday, November 5, 2009
Which patients sue for malpractice?
There are a lot of myths out there about which patients are most likely to sue a doctor for malpractice. Many doctors think it is "poor patients on welfare." They would be wrong. Evidence shows that low income patients on Medicaid are actually less likely to sue than others. But there are some patients and situations that should raise a red flag for physicians that they could bring a lawsuit.
--Angry patients: A patient who is upset about the doctor-patient relationship, either because something didn't work out or they perceived a lack of caring, is more likely to sue the doctor. Plaintiff attorneys say that the majority of their calls come from patients who had poor rapport with their physicians. What works in a medical error? An explanation of what went wrong and, if appropriate, an apology!
--Money Issues: Now that more patients are paying out of pocket costs, if they feel overcharged they become less tolerant of errors. If patients know the approximate costs up front, they aren't surprised and outraged when that big bill arrives. We all know, however, how hard it is to find out anything about costs in advance. Big problem!
--Doctors Dissing Others: So many lawsuits have been filed because of one doctor or nurse making disparaging remarks about another; "How did such a thing happen to you?" It's easy to be a Monday morning quarterback.
--Lousy Service: Bad service goes along with poor doctor-patient rapport. It is hard for someone to feel respected and cared for, if they get bad service or the rooms are dirty or the phone call isn't returned. If a mistake happens, the doctor must be available to discuss it. An absent doctor or poor service turns patients and family members into "angry patients" (see number 1).
Medical mistakes happen because the human body is complex, treatments are complex and there are no guarantees in life. Most patients don't sue their doctors when a bad outcome occurs. The experts in risk warn us that the relationship is the most important prevention for lawsuits, followed by meticulous documentation in the medical record.
Toni Brayer, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
Labels: malpractice, patient communication
posted by Toni Brayer MD at
7:00 AM
2 Comments
Friday, September 11, 2009
What did Obama mean?
Obama's nod to malpractice reform got Republicans on their feet the other night, but he was wisely vague about his specific intentions. A Washington Post article helpfully explains what the administration's approach to malpractice reform would likely really entail. As with the whole overall, the current plan sounds like it's along the lines of what he talked about during the campaign. Gets points for consistency, at the very least.
And, to compensate, some light reading for a gloomy (at least here in Philly) Friday afternoon--a CDC report of preschool teachers accidentally eating brownies spiked with pot. A couple of notes: First, California's medicinal marijuana laws must have made the drug awfully easy to come by that magic brownies are now selling on the street for $1.50. Second, one of the teachers went to the hospital and was treated with antibiotics. I'm no doctor but I'm pretty sure "being sky high" is an off-label use for any antibiotic.
Labels: drugs, health care reform, malpractice
posted by Stacey Butterfield at
2:23 PM
1 Comments
Wednesday, September 2, 2009
Patients just as likely to sue after apologies
Apologizing for a medical error in full and accepting responsibility may boost patients' perceptions of physicians but may not stop them from suing, according to simulations conducted at Johns Hopkins and reported in the Sept. 1 issue of the Journal of General Internal Medicine.
Researchers created simulated scenarios of three medical mistakes: a year-long delay in noticing a malignant-looking lesion on a mammogram, a chemotherapy overdose 10 times the intended amount and a slow response to pages by a pediatric surgeon for a patient who eventually codes and is rushed to emergency surgery. Actors played out levels of physician apology (full, non-specific and none) and acceptance of responsibility (full or none). 200 adult viewers then evaluated the simulations and reported their impressions. Sample videos used in this study are online.
Viewers who thought that the doctor had fully apologized and taken responsibility gave the doctors much higher ratings (81% vs. 38%; P<0.05) and would refer the doctor (56% vs. 27%; P<0.05), but weren't significantly moved not to sue (43% vs. 47%).
What's not reported in this study was whether the doctor could avoid being named in the eventual lawsuit. ACP's news magazines have reported in the past on ways to apologize and how it affects malpractice litigation.
Labels: malpractice, patient communication
posted by Ryan DuBosar at
10:35 AM
1 Comments
Tuesday, July 21, 2009
Apologizing for errors halves malpractice suits
University of Michigan Health System reports that admitting medical errors and offering compensation before being sued resulted in malpractice claims falling from 121 in 2001 to 61 in 2006, with corresponding savings in costs per claim.The Associated Press profiled the hospital system's efforts not only as a business decision but also an ethical one that benefits patients, while not exposing the system to further litigation.
Apologies aren't easy, but ACP's news publications have offered advice to make them easier:
--"Internist searches for answers when test results go missing," ACP Internist, April 2009.
--"Apologize like a pro," ACP Hospitalist, January 2008.
--"To err is human ... to not plan for it is trouble," ACP Hospitalist, December 2008.
--"Owning up to a mistake takes courage--and practice," ACP Internist, April 2009.
Also, PIER offers an entire module on disclosing medical errors, and Annals of Internal Medicine looked at the state-by-state efforts to implement shield laws for physicians who disclose errors.
Labels: ethics, malpractice, patient communication
posted by Ryan DuBosar at
10:34 AM
2 Comments
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