Hello Doctor. I Wouldn't Hesitate To Sue You

Guest post by Dr. Mandy Huggins

How many times during your day does the specter of a malpractice law suite rear its ugly head?

“I wouldn’t hesitate to sue you.”

"I’m sorry, what?"

That is what I heard from the mother of one of my patients. At the time, I was only 2-3 months into practice, and I was evaluating a high school athlete who had recurrent stingers and a possible episode of transient quadriparesis . I wasn’t on the sidelines for these injuries, so I had to go on the reports given to me by the athlete and the school’s athletic trainer. However, with that information, I did not want to clear this player to return to football until I could be certain he didn’t have cervical stenosis or any other abnormality that might put him at risk for permanent damage if he suffered another neck injury. I told the athlete and his mother that I needed to get an MRI of his cervical spine in order to determine this. The athlete was understandably upset with my decision, but his mother supported my decision to proceed with caution. She explained to me that if her son played again, sustained another injury, and something “bad” happened, she would be more than happy to take legal action against me.

Fantastic.

First of all, I can’t say that I would blame her for being angry (at the very least) if I screwed up. But to tell me in my office, to my face, that she’s already thinking about suing me? I found that ridiculous. I must be in the minority, however. If you Google “how to sue a doctor,” an abundance of information follows. There’s an “ehow” on the subject, and even CNN offers an opinion.

I’m sure many can offer some anecdote about how a physician did this or that wrong, and I agree that there are some bad apples out there. That’s not the point of this post. The point is, way too many people are looking, just waiting, for something to happen to they can “get theirs.” It’s disappointing, and quite frankly, very scary. I didn’t go through a lifetime of education and training to doubt everything I do for fear of a law suit. I’m lucky; my specialty is non-surgical and rarely deals with critical health issues. But I’m hardly in the clear. A 2011 study in the New England Journal of Medicine estimated that by the age of 65, “75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties.” So I have a 75% chance, give or take, that I’ll be named in at least one claim during my career. Of course, not all of these claims go to court and/or end up with the plaintiff being awarded, but you can see how frequently patients are quick to take action if they think they’ve been wronged.

I’ll continue to do what I’ve been trained to do – practice good, evidence-based medicine, communicate well with my patients, and document the you-know-what out of everything. But at the end of the day, the fear of a malpractice claim, valid or not, will always be in the back of my mind.

About: Dr. Mandy Huggins, MD is a sports medicine physician who practices in south Florida. She is board certified by the ABPMR and holds an added certificate of qualification (CAQ) in Sports Medicine. Learn more about Dr. Huggins at http://www.drmandyhuggins.com/. 

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Harvard Study: Most Physicians Will Be Sued

New England Journal of Medicine: Most doctors in America will be sued at some point during their career.

A Harvard study released yesterday in the New England Journal of Medicine has found that physicians who perform high-risk procedures, including neurosurgeons,  obstetricians, and thoracic surgeons, face a near certainty of being named in a malpractice case before they reach age 65.

Yet a relatively small number of claims, about 22 percent, result in payments to patients or their families.

Authors of the study, which examined 15 years of data, said it highlights the need for changes in malpractice law so that doctors and patients can resolve disputes before they resort to litigation, which often costs both parties money and heartache.

“Doctors get sued far more frequently than anyone would have thought, and in some specialties, it’s extremely high,’’ said Amitabh Chandra, an economist and professor of public policy at the Harvard Kennedy School and an author of the study. “In some sense, the payment is the least important part, because you can insure against it, but you can’t insure against the hassle cost.’’

The study looked at malpractice claims data for nearly 41,000 physicians from 1991 to 2005. The researchers found that 7.4% of physicians had a malpractice claim against them each year and that 1.6% had a claim that led to a payment each year.

Chandra and his coauthor, Dr. Anupam B. Jena of Mass. General, said they hope their study will dispel the fear that many doctors have of big payouts. Their study found just 66 claims that resulted in payments exceeding $1 million. Average claims by specialty ranged from $117,832 in dermatology to $520,923 in pediatrics.

So how can you lessen your chances of being sued by an unhappy patient even further?

Previous studies have shown that patients are less likely to sue when they receive an apology and explanation from their doctor.

Brian Rosman, research director of Health Care for All, said everyone will benefit if patient- doctor communication is divorced from legal proceedings and could actually inprove the quality of care. That would allow doctors and hospitals to deal more directly with the root cause of an error.

One medical society has been working with Beth Israel Deaconess Medical Center, using a $273,782 federal grant, to design a plan for a system that would encourage apologies and compensation, when justified, in Massachusetts. The plan is set to be released this fall.

It seems that nearly universal support exists for a system that encourages doctors to apologize and prevent the escalation of an unwanted outcome into a malpractice lawsuit.

Of course, this wall of scilence goes up on both sides. As soon as an unhappy patient contacts a lawyer they're instructed to have no further contact with the doctor to prevent anything that might mitigate damages or obstruct the lawsuit, like an admission to the doctor that they didn't follow instructions or a 'softening' of their stance as the identify with the physician as a person.

When I was running Surface Medical we ran in to this very problem many times.

Have you been in a lawsuit? Have you ever appologized to a patient?