Only the Rude Get Sued

Why is it that the vast majority of people who are injured as a result ofmedical negligence don't sue for malpractice?

It all comes down to interpersonal skills, say Vanderbilt University researchers.

They interviewed 963 Florida women about their level of satisfaction with their obstetrician-gynecologist, none of whom they had sued for malpractice. The physicians, meanwhile, were sorted into four groups, depending on how frequently they had been sued.

A panel of experts, who didn't know which doctor group was which, examined their medical records for clues to competence. The experts couldn't find differences in the quality of care among the doctors who had been sued least and sued most, even when asked if they would send a relative to see the physician in question.

"We found profound differences between the groups when it came to the doctor-patient relationship, reports Gerald Hickson, M.D., in the Journal of the American Medical Association. The doctors who were sued the most elicited twice as many complaints from the women as those who had never been sued. Invariably, the women felt that they were rushed or ignored on their visits, or that their questions were not answered.

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"lt's just not in the nature of these doctors to pay adequate attention to their patient relationships," says Hickson. And it clearly comes back to haunt them.

Say a child is born with unexplained health problems. A family whose questions are ignored following a problematic delivery are more apt to question their obstetrician's competence--in court.

"The tragedy is that the doctors who acquire many claims never understand why," comments Hickson. He proposes review systems that look not just at a single suit, but the pattern of complaints--and gives the physician feedback on interpersonal skills.

Hickson thinks things are getting better. "Medical schools are finally recognizing the therapeutic effect of a good doctor-patient relationship and its preventive effects in malpractice.

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