Criticism from other physicians can fuel suit
Executive Summary
Physicians criticize the care of other physicians with surprising frequency even if the standard of care has been met, according to a recent study. Tis criticism can fuel malpractice risks. If physicians disagree with previous care, they should do the following:
- Adivse the patient to get a second opinion.
- Contact the patient's previous physician to discuss the care.
- Avoid criticism by creating detailed, coherent, and complete records.
Critical comments are surprisingly common
When researchers set out to learn how doctors talked about other doctors to a group of 34 seriously ill patients, they found something surprising. More than one-third (38%) of physicians criticized a patient’s previous care, despite the fact that the patients didn’t ask for their opinion.1
Also, the patient’s charts showed that the standard of care had been met. "So the fact that the care was criticized meant something different than if there had actually been poor care delivery," says Susan H. McDaniel, PhD, the study’s lead author and associate chair of the Department of Family Medicine at the University of Rochester (NY) Medical Center.
The researchers initially were looking for comments involving empathy and self-disclosure. "But what popped out at us was a lot of criticism by one physician of another," says McDaniel. "We didn’t set out to study this, but we found it, as happens in a qualitative study."
If physicians genuinely are concerned, McDaniel says a better approach would be to advise the patient to get a second opinion or contact the physician to discuss the care directly.
When physicians complain about the care provided by another physician, it causes patients to wonder whether malpractice occurred, she says. "It makes patients very uncomfortable for their physicians to criticize each other," says McDaniel. "It can fuel uncertainty and anxiety, and in some cases, even malpractice suits."
Common reason for suits
Jack H. Olender, JD, a Washington, DC-based plaintiff’s malpractice attorney, often is informed by a prospective client that a follow-up treating physician said that the treatment given was improper, not indicated, or negligently administered.
"Sometimes these allegations are borne out by the records and the total picture of what happened, and sometimes they are not," says Olender.
The physician who allegedly made the statement isn’t necessarily willing to cooperate with a plaintiff attorney. Some deny ever making the comment. "However, the physician’s criticism may indeed be the deciding reason for the patient to seek legal counsel," he says.
If physicians learn another physician criticized their care, Olender says they "should not do anything, other than wait for the other shoe to drop — or, for nothing to happen" and not make matters far worse by altering or deleting existing records. "Such actions can turn a so-so case into a locked case or even criminal prosecution," he warns.
Physicians who make detailed, coherent and complete records are unlikely to encounter criticism from other physicians, Olender says. "It is the sketchy, unclear records that produce the criticism," he says. "The same is true with the quality of the communication with the patient." If physicians explain something clearly, the patient presumably will have fewer questions for follow-up physicians. "Perhaps the single best way to prevent criticism from other physicians is to take the time and effort to render excellent care," says Olender.
Reference
- McDaniel SH, Morse DS, Reis S, et al. Physicians criticizing physicians to patients. J Gen Intern Med 2013; 28(11):1405-1409.
