Many malpractice suits are brought not because of malpractice nor even because of complaints about the quality of medical care but as an expression of anger about some aspect of patient-doctor relationships and communications. The theory presented is that under the stress of anxiety and physical illness, some patients regress to childhood needs; physicians are not generally trained to fill such needs. Thus, these patients, angry because of this, express their anger in malpractice suits. This theory has been taught to physicians and medical students as part of a physician continuing medical education (CME) seminar on Loss Prevention/Risk Management through demonstration of active-listening techniques to seminar participants. Physicians who understand and can respond appropriately to the emotional needs of their patients are less likely to be sued. This may also translate into a more fulfilled practice of medicine by those physicians who are most aware of the importance of a positive relationship.

No abstract

A review of the literature suggests that the causes of addiction in the physician include: 1) a genetic component; 2) a dysfunctional family; 3) a college atmosphere where alcohol is part of the ritual of passage; 4) self-selection of a medical school career by introverts and over-achievers; 5) unrealistic expectations of medical school and a medical career; 6) the suppression of feelings and avoidance of intimacy in medicine; 7) the insensitivity of some faculty, amounting in some cases to abuse; and 8) the various other stresses of medical training, practice, and life. Primary prevention programs described in the literature include education about alcoholism and drug abuse, stress management skills education, encounter and discussion groups, workshops, and counseling. An important element in preventing addiction in the physician is the psychological ability to cope with the serious stresses which will inevitably be encountered. Suggestions are offered for a course that will improve the ability of students to cope with these stresses.

No abstract