Truthful Doctors May Prevent Malpractice Suits

Joe Cantlupe, for HealthLeaders Media , February 16, 2012

"We order too much, (practice) too much defensive medicine, keep patients in hospitals too long," Douglas Garland, MD told HealthLeaders Media. He is medical director of the MemorialCare Joint Replacement Center, part of the 1,006-bed MemorialCare Health System in Long Beach, CA.

Results of a recent survey published in Health Affairs revealed that as many as 20% of physicians won't tell patients about errors because of doctors' fear of malpractice litigation.  As many as 55% exaggerated or failed to tell patients something about their health because, in part, the physicians didn't want to upset their patients. At least 1 in 10 physicians told patients something untrue in the past year.

"When we noted that 20% of physicians said in the last year they had not fully disclosed an error or a mistake to a patient because they were afraid of a lawsuit, it certainly could have been any error they were referring to," Lisa I. Iezzoni, MD, M.Sc, a professor of medicine at Harvard University and director of the Mongan Institute for Health Policy at Massachusetts General Hospital told HealthLeaders Media.

"We don't know from the survey results; we didn't ask that. But you can imagine the errors span a continuum of severity. Some errors may have caused minor discomfort or no discomfort whatsoever. Other errors can be life-threatening. It's hard to know exactly what that 20% remembered; they weren't asked that question," she says.

While physicians' statements are not always linked to malpractice concerns, doctors  are aware that the possibility of litigation is always a factor. Indeed, more than 60% of physicians aged 55 and older have been sued at least once, according to the American Medical Association.

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2 comments on "Truthful Doctors May Prevent Malpractice Suits"

Deb Levy (2/16/2012 at 4:23 PM)
I can tell you from personal experience that it's true admitting a mistake can save a world of hurt. There was a mix-up in the size of the knees replacement in the OR and 3 days post-op the femur fractured. After the open internal fixation of the fracture the surgeon told of the error and the possiblity that was the reason for the fracture. I so appreciated the honesty that when further complications occurred & he said the treatment was best done by subspecialist I trusted him. Even after the leg ended up being amputated (due to a multitude of complications) I never considered suing, although there were plenty of people who said we should. Never once have I regretted not suing. Heaven couldn't have helped him had I found out the error some way other than him telling me!

C Ghosh (2/16/2012 at 3:51 PM)
Sadly this HealthLeaders study falls into the trap so many other similar studies do: It makes the assumption that there actually is something called "defensive medicine" and that doctors are consciously doing extra testing for fear of a lawsuit. Doctors, who have been accused of driving up national medical costs by over ordering testing, have defensively fallen back on the "fear of malpractice made me do it" excuse. The truth is EVERY TIME a doctor orders a test, the doctor needs that extra information. For example, if a patient has a cut on her hand, her doctor won't order a CT Scan of her foot. NEVER. A headache may warrant a CT Scan because we don't know what's causing it. While health economists see this as extra testing, it's not to the doctor who is trying to make the correct diagnosis. Doctors have been so conditioned to think that anything the outside experts may think as superfluous is "defensive medicine," that doctors themselves label every extra test as "defensive medicine." The real kicker in this survey is that only 2% ordered for financial gain.




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