Sue me once, shame on you; sue me twice . . . .
A doctor who has been sued for malpractice is far more receptive to risk management directives than a doctor who has not yet experienced the thrill of being in a courtroom. Risk management education can even have a negative effect on physicians who have not yet been sued.
Those are some of the results presented by researchers at a conference on health care errors in Rancho Mirage, CA, sponsored by the American Association for the Advancement of Science, the American Medical Association, and the Annenberg Center for Health Sciences. The results came from a study of 1,903 office-based physicians enrolled in the Oregon Medical Association’s medical liability program, conducted by Paul R. Frisch, JD, director of medical-legal affairs for the state association, and Sara C. Charles, MD, emeritus professor of psychiatry at the University of Illinois College of Medicine at Chicago.
Frisch and Charles report that a doctor’s first malpractice claim seems to knock down the psychological defense mechanism that leads many to think lawsuits happen to other people. That, in turn, makes them more receptive to advice and education from risk management professionals. The researchers suggest that the best time to provide risk management advice is immediately after the doctor’s first claim. Their work also suggests that risk management courses have a measurable effect in lowering the chance of future lawsuits.
The conclusions are based largely on an analysis of when doctors were sued and when they participated in risk management education activities. OB-GYNs and anesthesiologists appeared to respond especially well to risk management efforts after their first lawsuit. Among OB-GYNs who had been sued once, for instance, the rate of subsequent lawsuits was 23.3% per year if they did not participate in risk management activities. If they took at least two courses, the rate dropped to 15.2%.
But among OB-GYNs who had never been sued, the rate of a malpractice claim was 11.5% per year. After taking a risk management course, the rate increased to 17.8%. The increase could be a statistical anomaly, so it is not certain that risk management education has any detrimental effect just because the doctor has not yet been sued.
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