The doctor-patient relationship and malpractice. Lessons from plaintiff depositions
- PMID: 8002688
The doctor-patient relationship and malpractice. Lessons from plaintiff depositions
Abstract
Background: The current literature does not provide an answer to the question, "What prompts patients to sue doctors or hospitals?" Not all adverse outcomes result in suits, and threatened suits do not always involve adverse outcomes. The exploration of other factors has been hampered by the lack of a methodology to contact plaintiffs and elicit their views about their experience in delivered health care. This study employed the transcripts of discovery depositions of plaintiffs as a source of insight into the issues that prompted individuals to file a malpractice claim.
Methods: This study is a descriptive series review of a convenience sample of 45 plaintiffs' depositions selected randomly from 67 depositions made available from settled malpractice suits filed between 1985 and 1987 against a large metropolitan medical center. Information extracted from each deposition included the alleged injury; the presence of the question, "Why are you suing?" and, if present, the answer; the presence of problematic relationship issues between providers and patients and/or families and, if present, the discourse supporting it; the presence of the question, "Did a health professional suggest maloccurrence?" and, if yes, who. Using a process of consensual validation, relationship issues were organized into groups of more generalized categories suggested by the data. Answers to the questions, "Why are you suing?" and "Who suggested maloccurrence?" are described.
Results: Problematic relationship issues were identified in 71% of the depositions with an interrater reliability of 93.3%. Four themes emerged from the descriptive review of the 3787 pages of transcript: deserting the patient (32%), devaluing patient and/or family views (29%), delivering information poorly (26%), and failing to understand the patient and/or family perspective (13%). Thirty-one plaintiffs were asked if health professionals suggested maloccurrence. Fifty-four percent (n = 17) responded affirmatively. The postoutcome-consulting specialist was named in 71% (n = 12) of the depositions in which maloccurrence was allegedly suggested.
Conclusions: In our sample, the decision to litigate was often associated with a perceived lack of caring and/or collaboration in the delivery of health care. The issues identified included perceived unavailability, discounting patient and/or family concerns, poor delivery of information, and lack of understanding the patient and/or family perspective. Particular attention should be paid to the postadverse-event consultant-patient interaction.
Comment in
-
Doctor-patient communication and medical malpractice: an ambiguous relationship.Arch Intern Med. 1995 Mar 13;155(5):543. doi: 10.1001/archinte.155.5.543b. Arch Intern Med. 1995. PMID: 7864711 No abstract available.
Similar articles
-
Fathers and the well-child visit.Pediatrics. 2006 Apr;117(4):e637-45. doi: 10.1542/peds.2005-1612. Pediatrics. 2006. PMID: 16585280
-
[The analysis of physicians' work: announcing the end of attempts at in vitro fertilization].Encephale. 2003 Jul-Aug;29(4 Pt 1):293-305. Encephale. 2003. PMID: 14615699 French.
-
The patient's view.Med J Malaysia. 2003 Mar;58 Suppl A:86-101. Med J Malaysia. 2003. PMID: 14556356 Review.
-
Surgical adverse events, risk management, and malpractice outcome: morbidity and mortality review is not enough.Ann Surg. 2003 Jun;237(6):844-51; discussion 851-2. doi: 10.1097/01.SLA.0000072267.19263.26. Ann Surg. 2003. PMID: 12796581 Free PMC article.
-
Reproductive health and blurred professional boundaries.Womens Health Issues. 1996 Mar-Apr;6(2):89-96. doi: 10.1016/1049-3867(95)00078-X. Womens Health Issues. 1996. PMID: 8932462 Review.
Cited by
-
From systematic complaint analysis to quality improvement in healthcare.BMJ Open Qual. 2024 May 23;13(2):e002637. doi: 10.1136/bmjoq-2023-002637. BMJ Open Qual. 2024. PMID: 38782487 Free PMC article. No abstract available.
-
Client satisfaction and contributing factors towards sexual and reproductive health services delivery system among youth at Family Guidance Association of north Ethiopia (FGAE) clinics, 2023: mixed method study.BMC Health Serv Res. 2024 Apr 16;24(1):473. doi: 10.1186/s12913-024-10874-8. BMC Health Serv Res. 2024. PMID: 38627738 Free PMC article.
-
Empathy Among Internal Medicine Residents in a Community-Based Training Program: A Pilot Study.MedEdPublish (2016). 2017 Apr 26;6:77. doi: 10.15694/mep.2017.000077. eCollection 2017. MedEdPublish (2016). 2017. PMID: 38406443 Free PMC article.
-
Understanding the User's Point of View: When the Doctor Gets Sick with Cancer and Seeks Help.Clin Pract Epidemiol Ment Health. 2023 Oct 13;19:e17450179241325. doi: 10.2174/0117450179241325231011070735. eCollection 2023. Clin Pract Epidemiol Ment Health. 2023. PMID: 38164454 Free PMC article.
-
Communication of medical errors in a simulated clinical scenario. Experience with a pediatric residency group.Rev Paul Pediatr. 2023 Jul 10;42:e2022109. doi: 10.1590/1984-0462/2024/42/2022109. eCollection 2023. Rev Paul Pediatr. 2023. PMID: 37436240 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical