February 5, 2013

Which patients are most likely to file malpractice suits

Daily Briefing

    Legal experts say some patients are quicker to sue their doctors than others—and taking proactive steps with those patients can help reduce a physician’s legal risks.

    “[T]here’s going to be a subset of individuals who are more likely to sue than others. There are individuals who walk in and are ready to be unhappy,” says Gerald Hickson, director of the Center for Patient and Professional Advocacy at Vanderbilt University School of Medicine.

    Based on legal experts and various studies, American Medical News outlines some of the key characteristics of lawsuit-prone patients:

    • Wealthy patients: A 2012 study in Clinical Orthopaedics and Related Research found that wealthier patients are more likely to sue than patients with lower household incomes, partly because patients without financial means are also likely to not have access to legal counsel. Moreover, Medical Risk Institute CEO Michael Sacopulos says patients who are likely to sue tend to have high social statuses, high education levels, and live in urban areas.

    • Patients with medical or legal connections: If the patient personally knows a physician or an attorney, they are more likely to file a malpractice lawsuit, according to Mark Horgan, senior vice president for claims at professional medical liability insurer CRICO. "You would think it would make for a more rational conversation after an event, but there are some occasions where clinicians are really critical of one another," Horgan says.

    • Demanding, hard-to-satisfy patients: Physicians should be wary of new patients who say they have been "mistreated" by other physicians and seem difficult to "satisfy,” says Sacopulos.

    • Patients who demand specific procedures: Patients who demand or beg for a procedure can be a litigation red flag, according to vice president for primary care at Eisenhower Medical Center Joseph Scherger. He contributed to a 2011 project called "The Legal Risk Patient" through QuantiaMD—an online physician learning collaborative. "[T]he patient who is very demanding about what they want and expect you to give them, 'or else,' puts you on guard,” Scherger told American Medical News

    • Patients who have sued a co-worker: Legal experts say that physicians should be careful when accepting patients that have sued a physician who works in their practice. “If they've sued your partner, whether or not they would ever sue you, it certainly puts people in an awkward position," says Sacopulos.

    How physicians can proactively prevent malpractice lawsuits

    According to "The Legal Risk Patient," physicians can prevent malpractice suits by:

    • Carefully documenting patient conversations, treatments, and clinical evaluations;
    • Encouraging secure online communication with the patient, so there is documentation on both sides;
    • Focusing on getting to know the patient and building trust;
    • Being transparent by carefully explaining all medical treatments and diagnoses;
    • Asking if the patient has any questions; and
    • Apologizing when appropriate if a problem arises. 

    When to cut ties with a patient

    If a patient is continuously dissatisfied with a physician’s care, physicians should consider ending the relationship, medical experts told American Medical News.

    In those instances, physicians should follow the appropriate guidelines to prevent an "abandonment" claim, says Richard Roberts, president of the World Organization of Family Doctors (Gallegos, American Medical News, 2/4).

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