The doctor-patient relationship and malpractice. Lessons from plaintiff depositions

Beckman, Howard

doi:10.1001/archinte.154.12.1365

Cited by 319 publications

(295 citation statements)

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“…In addition we made no attempt to rank PROMs in terms of how frequently they appear in the literature. Non-English PROMs were not assessed as most readability scores are not validated for use in any other With the majority of medical negligence claims related to poor communication, it is essential that written healthcare material be easily understood [10]. In 1999 Tampa General Hospital paid USD 3.8 million in compensation because signed consent forms were written at a level that exceeded patients' understanding [46,99].…”

Section: Discussionmentioning

confidence: 99%

Are Patient-reported Outcome Measures in Orthopaedics Easily Read by Patients?

El-Daly

Ibraheim

Rajakulendran

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Patient-reported outcome measures (PROMs) are commonly used by healthcare providers as means of assessing health-related quality of life and function at any given time. The complexity of PROMs can differ and when combined with varying degrees of adult literacy, error can be introduced if patients fail to understand questions. With an average adult literacy level of 11-year-old students in the United Kingdom, it is unclear to what degree PROMs can be read and understood by most patients (readability); to our knowledge, this has not been evaluated. Questions/purposes We wished to determine the readability of commonly used PROMs in orthopaedic surgery, as assessed by a validated tool that measures the complexity of the language in these surveys. MethodsWe performed a MEDLINE search to identify the most-commonly reported PROMs in orthopaedic research. One hundred twenty-one PROMs were identified and reviewed by 19 attending orthopaedic surgeons at our institution. Fifty-nine were selected as the most commonly used in our department. Of these, 52 (78%) were disease specific and included: 12 (20%) knee, 10 (17%) shoulder, seven (12%) spine, six (10%) hip, five (8%) foot and ankle, four (7%) elbow, three (5%) pelvis, three (5%) hand and wrist, and two (3%) lower limb. The remaining seven (12%) PROMs were general health questionnaires. The Flesch Reading Ease Score is a validated readability tool measuring average sentence length and syllables per word. It is expressed on a scale from 0 to 100 with higher scores indicating easier reading. We extracted the text from each PROM and inserted it in the same online Flesch Reading Ease Score calculator to generate a score. Results The mean readability score was 55 (range, 0-93), corresponding to text best understood by 16-to 18-year-old

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Section: Discussionmentioning

confidence: 99%

Are Patient-reported Outcome Measures in Orthopaedics Easily Read by Patients?

El-Daly

Ibraheim

Rajakulendran

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…The first is that hospitalists have only a brief relationship with their patients, thus limiting their ability to form the strong physician-patient relationships that decrease the likelihood of a malpractice claim. [14][15][16][17] Second, hospitalists face the challenge of transitions of care as patients move from the outpatient to the inpatient setting, and vice versa. 4,7,18,19 Despite these theoretical concerns, we found that hospitalists face a relatively low rate of claims compared to other physicians.…”

Section: Schaffer Et Al | Liability Of Hospitalist Model Of Carementioning

confidence: 99%

“…In prior research, an inadequate physician-patient relationship has been found to be a factor in patients deciding to file a malpractice claim. [14][15][16][17] Although hospitalists usually only care for their patients during the few days of the hospital admission, hospitalists are on site all day and thus are able to frequently communicate with patients and families face to face. This level of interaction may allow for a sufficiently healthy, even if time-limited, physician-patient relationship that meets patients' expectations.…”

Section: Schaffer Et Al | Liability Of Hospitalist Model Of Carementioning

confidence: 99%

Liability impact of the hospitalist model of care

Schaffer

Puopolo²,

Raman³

et al. 2014

Journal of Hospital Medicine

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BACKGROUND An increasingly large proportion of inpatient care is provided by hospitalists. The care discontinuities inherent to hospital medicine raise concerns about malpractice risk. However, little published data exist on the medical liability risks associated with care by hospitalists. OBJECTIVE We sought to determine the risks and outcomes of malpractice claims against hospitalists in internal medicine. DESIGN Retrospective observational analysis. MEASUREMENTS Using claims data from a liability insurer‐maintained database of over 52,000 malpractice claims, we measured the rates of malpractice claims against hospitalists compared to other physician specialties, types of allegations against hospitalists, contributing factors, and the severity of injury in and outcomes of these claims. RESULTS Hospitalists had a malpractice claims rate of 0.52 claims per 100 physician coverage years (PCYs), which was significantly lower than that of nonhospitalist internal medicine physicians (1.91 claims per 100 PCYs), emergency medicine physicians (3.50 claims per 100 PCYs), general surgeons (4.70 claims per 100 PCYs), and obstetricians‐gynecologists (5.56 claims per 100 PCYs) (P < 0.001 for all comparisons). The most common allegation types made against hospitalists were for errors in medical treatment (41.5%) and diagnosis (36.0%). The most common contributing factors underlying claims were deficiencies in clinical judgment (54.4%) and communication (36.4%). Of the claims made against hospitalists, 50.4% involved the death of the patient. CONCLUSIONS Despite fears of increased liability from the hospitalist model of care, hospitalists in internal medicine are subject to medical malpractice claims less frequently when compared to other internal medicine physicians and specialties. Journal of Hospital Medicine 2014;9:750–755. © 2014 Society of Hospital Medicine

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“…Similarly, among the reasons that claimants interviewed by Hickson and colleagues [18] gave as motivating their lawsuits were the belief that ''the courtroom was the only forum in which they could find out what happened from the physicians who provided care'' (20%), the belief ''that physicians had failed to be completely honest with them about what happened, allowed them to believe things that were not true, or intentionally misled them'' (24%), and a desire to ''deter subsequent malpractice by the physician and/or to seek revenge'' (19%) [18]. Other studies have similarly found failure to provide explanations and poor communication generally are associated with litigation [1,19,21,34,35,48].…”

Section: Apologies and Patientsmentioning

confidence: 99%

Apologies and Medical Error

Robbennolt

2009

Clinical Orthopaedics &Amp; Related Research

106

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One way in which physicians can respond to a medical error is to apologize. Apologies-statements that acknowledge an error and its consequences, take responsibility, and communicate regret for having caused harmcan decrease blame, decrease anger, increase trust, and improve relationships. Importantly, apologies also have the potential to decrease the risk of a medical malpractice lawsuit and can help settle claims by patients. Patients indicate they want and expect explanations and apologies after medical errors and physicians indicate they want to apologize. However, in practice, physicians tend to provide minimal information to patients after medical errors and infrequently offer complete apologies. Although fears about potential litigation are the most commonly cited barrier to apologizing after medical error, the link between litigation risk and the practice of disclosure and apology is tenuous. Other barriers might include the culture of medicine and the inherent psychological difficulties in facing one's mistakes and apologizing for them. Despite these barriers, incorporating apology into conversations between physicians and patients can address the needs of both parties and can play a role in the effective resolution of disputes related to medical error.

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The doctor-patient relationship and malpractice. Lessons from plaintiff depositions

Cited by 319 publications

References 0 publications

Are Patient-reported Outcome Measures in Orthopaedics Easily Read by Patients?

Are Patient-reported Outcome Measures in Orthopaedics Easily Read by Patients?

Liability impact of the hospitalist model of care

Apologies and Medical Error

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