Thursday, November 5, 2009

Who Sues 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.


Anonymous said...

You are right. A doctor inserted a chest tube on the wrong side on my father. He never explained and just let the resident deal with my dad's hospital care. We were so angry at his callous behavior. We never thought of suing until we realized he just didn't care.

Michael Kirsch, M.D. said...

Toni, None of your 4 reasons that patients sue include negligent care. I agree with your analysis,which supports the view that the current system is not designed to target true negligence. Personally, I think that the legal system is more dysfunctional than the health care system. Most physicians drawn into the legal arena are innocent. Sure, most are released, but this can take months or years. this adversely affects our doctor-patient relationships. Defensive medicine, a direct result of physician legal fear, costs at least tens of billions of dollars and exposes our patients to unnecessary risk and expense. Finally, as you imply in your post, most patients who are true victims of medical negligence are missed entirely by the current system? Is the status quo the best we can do? under Legal Quality may be of interest.

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