Does Poor Communication Lead to Medical Malpractice Claims? By Floyd Arthur (PPT) http://carmoongroup.com

1. Does Poor Communication
Lead to Medical Malpractice
Claims?
By Floyd Arthur

2. Despite the hoopla around
the recent Stanford
University study on the
incidence of

3. malpractice lawsuits,
physicians have known for
some time that a small
percentage of

4. doctors account for the bulk
of medical malpractice
claims.

5. Medical Malpractice Claims

6. In fact, studies from as far
back as the 1980s show that
the best predictor of being
sued

7. for malpractice is being sued
before. More importantly,
this holds true for both paid

8. claims and unpaid claims.

9. In other words, even doctors
who are cleared of any
wrongdoing are more likely
to be sued again.

10. This begs the question: Why?
Are these doctors just victims
of bad luck? Are they

11. actually making more
mistakes? Or are other
factors in play?

12. According to numerous
studies, ineffective
communication -- not
medical negligence --

13. may be largely to blame.

14. Why Patients File Medical
Malpractice Claims

15. A common belief among
many physicians is that
patients file medical
malpractice claims

16. for financial gain. In one 1989
study, 80 percent of doctors
said they thought patients

17. filed malpractice suits for
financial reasons, while only
20 percent of patients said
that was the case.

18. In a 1992 study, the parents of
children who suffered birth
injuries were asked why they

19. filed a medical malpractice
claim. About one in four said
they “needed money.” Most
of

20. the other reasons they gave
were related to not getting
needed information or a

21. perceived lack of honesty on
the part of the physician
being sued. These included:

22. * Doctor did not listen to
them (13 percent)

23. * Doctor would not talk
openly (32 percent)

24. * Doctor tried to mislead
them (48 percent)

25. * Doctor did not warn them
about long term
complications (70 percent)

26. About one in five families
sued to seek revenge or
protect other patients from
harm.

27. Does Improved
Communication Decrease
Medical Malpractice Claims?

28. Since the first medical
malpractice lawsuit was filed
in 1794, physicians and their

29. attorneys have used the
“deny and defend” strategy
to protect against malpractice

30. claims. Physicians who knew
they made a medical error
were encouraged to hide it
from

31. the patient, and errors that
could not be hidden were
rarely discussed. Hospital

32. “Morbidity and Mortality”
conferences were for
physicians only and held
behind closed doors.

33. Ano no one ever said “I’m
sorry” because an apology
was an admission of guilt.

34. Over the past two decades,
however, many U.S. hospitals
have reversed this approach,

35. encouraging doctors to
disclose errors at the time
they occur. At the University
of

36. Michigan, which initiated the
practice 15 years ago, the
number of lawsuits dropped
68 percent in six years.

37. When the University of
Illinois instituted a similar
policy in 2006, malpractice
lawsuits

38. dropped by nearly 50
percent.

39. Since then, many hospitals
and medical centers have
followed suit. Both the Joint

40. Commission on Hospital
Accreditation and the
American Medical
Association have

41. encouraged hospitals and
doctors to open lines of
communication with patients
and

42. families in order to decrease
the burden of medical
malpractice claims.

43. Improving Communication
Not an Easy Task

44. Disclosing medical errors is
an important aspect of
physician-patient
communication,

45. but it is by far not the only
one. Ineffective
communication between
patients and their

46. doctors also contributes to
the preventable medical
errors that often lead to
malpractice suits.

47. Nonetheless, communicating
effectively in today’s
healthcare environment is
difficult, to

48. say the least. In an essay
published in the Wall Street
Journal in 2013, Harlan
Krumholz

49. sums up the problem nicely
when he describes the
“production mentality that
focuses

50. intently on relative value
unit, the currency of medical
output, rather than the
results

51. achieved with patients—
including the nature of the
relationships.”

52. How can a doctor engage in a
meaningful dialogue when
he is typing information into

53. an EHR as the patient talks?
How can a physician
establish rapport and
empathy when

54. the average patient visit is 11
minutes long?

55. One solution may be to use
more of those allotted
minutes listening to what the
patient

56. has to say, says Alex
Lickerman, an internist who
is the director of the
university

57. Student Health and
Counseling Services at the
University of Chicago
Medical School.

58. And at least a few studies
seem to bear him out.
According to one 1999 study
of primary

59. care physicians, doctors let
patients talk for 23 seconds
before redirecting them to

60. something else, and only one
in four patients were able to
finish what they had to say.
In

61. another study done at the
University of North Carolina
in 2001, patients were

62. interrupted after only 12
seconds, either by the
physician himself or an
intrusion, such

63. as a beeper or knock on the
door.

64. “People feel dissatisfied
when they don't get a chance
to say what they have to say,"
says

65. Lickerman. “It's not the
actual time or lack of time
people are complaining
about — it's how that time
felt."

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