Human InterestPhysician Office IssuesUncategorized

EVEN THE BEST DOCTORS ARE SUED!

A recent article in Medical Economics online magazine states that 31% of physicians are sued at some point in their careers. That means almost one-third of all physicians who frequently have long careers, are sued at least once. Very few things in medicine get physicians upset as much as being sued! Doctors are taught to be independent and thus develop a feeling of self-confidence. Their egos sometimes get in the way of rational thinking so when they are sued, doctors’ minds go crazy with anger, disbelief, and resentment. “I was providing the best care I could, and some lawyer says I screwed up! How dare he sue me!”

Well, it happens, and you have to deal with it. You can’t let yourself be made to feel inadequate because even the most knowledgeable, competent, highly qualified physicians get sued. Statistics being what they are tell several stories that give a perspective to being sued. The first has to do with a physician’s age; the longer one is in practice the more likely he/she is to be sued. Of physicians under age 40, only 9.5% have been sued while of those age 54 and older 46.8% have been sued. Time and repeated exposure to difficult medical dilemmas take their toll in the medical malpractice realm. 

A physician’s specialty factors in as well. Surgical sub-specialties are more susceptible to lawsuits than are internal medicine specialties. Sixty-two percent of OB-GYNS and 59.3% of general surgeons are sued during their careers, compared to allergists and oncologists where 7% and 8% of them, respectively, are sued. 

Women are sued significantly less often than men—23.8% to 36.8%— in their careers. Women are seen as gentler, more caring and understanding than the often authoritarian, paternalistic demeanor of many men. This translates not to better care, but to better rapport and trust.

Employed physicians face fewer lawsuits than do private practice physicians. 28.7% of employed docs and 35.4% of private doctors are sued during their careers. I have no explanation for this difference. In fact, it is counter to what I might have expected. 

Being accused of medical malpractice really bruises the ego of a physician. As mentioned above, anger dominates one’s thoughts. Resentment is unbridled and embarrassment puts one on the defensive. “Will my patients find out?” Dealing with a lawsuit takes time away from one’s practice and patient care plus it distracts the doctor’s mind from focusing on the problem presented by the current patient. 

There is good news, however. “When physicians are sued, two-thirds of civil liability claims are dropped, dismissed, or withdrawn without a finding of fault. When claims (lawsuits) proceed to trial, and are decided by a verdict, the defendants (physicians) prevail (are innocent) in nearly 90% of cases.” That’s good for doctors, but the path to that outcome is fraught with a load of anxiety.

The best deterrent for a malpractice suit is to practice good quality medicine. Be careful not to say the wrong thing. Don’t insult or “talk down” to the patient. Communicate effectively by listening, not interrupting, and making eye contact. Be present when setbacks occur. Examine the patient, ie. lay on hands. Don’t hesitate to refer to specialists. Be the “go-to” doctor at times of illness or problems. Document completely in the medical record and do not alter it after the fact. 

Medical malpractice hasn’t been in the news much in recent years. States have enacted laws which have lessened the penalty to doctors, controlled outrageous jury awards to plaintiffs, and produced procedures that deflect frivolous lawsuits. Still on a yearly basis between 1.8% to 2.5% of all physicians are sued. The percentage is declining, fortunately. The main gist of the references cited is that there is no association between health care quality and outcomes and medical malpractice. An AMA spokesman stated, “ All medical care comes with risks, yet physicians are willing to perform high-risk procedures that offer hope of relief…..even the most highly qualified and competent physicians may face a medical liability claim……getting sued is not indicative of medical errors.”

I think a lot of plaintiffs would disagree with that assessment as would doctors put through the humiliation of a trial. They’re not referring to cases of obvious negligence where a sponge was left in the belly or the wrong knee was operated on, but more, cases of clash of personalities, unreasonable expectations by the patient, or a simple misunderstanding or miscommunication. Those are resolved out of court and comprise the 90% statistic. 

Any malpractice lawsuit, though, carries with it a stigma the physician never forgets, and an outcome the patient lives with forever. Avoiding situations susceptible to litigation is the always best policy.

References: https://www.medical economics.com/view/see-you-in-court-31-_23_MEC_

Mello MM, Frakes MD, Blumenkranz E, Studdert DM. Malpractice Liability and Health Care Quality: A Review. JAMA 2020 Jan 28;323(4):352-366.

https://www.ncbi.nlm.nih.gov/books/NBK470573/
https://journals.lww.com/ajg/citation/2010/01000/what-do-most-doctors-win-in-a-medical-malpractice-lawsuit.47.aspx

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