Strategic Risk Management: Reducing Malpractice Claims Through More Effective Patient-Doctor Communication

Abstract

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.

Providers’ Perceptions of Relationships and Professional Roles when Caring for Patients who Leave the Hospital Against Medical Advice

“…34,35 Scholarship in this domain discusses risk management strategies, noting that improving patient-physician communication can lead to decreased patient complaints and fewer malpractice claims. 36,37 Articles also articulate the importance of careful and thorough documentation of the actions taken by the patient and the provider in the sequence of events that lead up to and include leaving the hospital AMA. 34 These legal and procedural themes echo loudly in providers' thoughts as they try to balance patient autonomy, potential harm, and beneficence.…”

Attitudes and behaviors of physicians in dealing with difficult patientsand relatives: a cross-sectional study in two training and research hospitals

“…Failure to establish an effective physician-patient relationship may disrupt the execution of health-care services effectively in daily practice, delay the treatment of patients, cause physicians to feel exhausted psychologically, cause discontentment of both physicians and patients, and lead to legal issues (20)(21)(22). All these conditions cause health-care facilities to be used more than necessary, much more laboratory testing to be performed, unnecessary medications to be prescribed, and as a result increased healthcare costs (22)(23)(24).…”

La importancia de la Escucha Activa en la intervención Enfermera

“…3. Demostrar al interlocutor que se está dispuesto a escucharle: se trata de adoptar una posición abierta y activa 33,34 , manifestándole claramente nuestro interés y escuchándole para tratar de entenderle y no para oponernos, lo que se suele hacer mediante movimientos afirmativos de cabeza y palabras del estilo de "sí, sí", "ya veo", resumir y confirmar las afirmaciones de quién nos trasmite el mensaje 35,36 , formulando las frases con una tonalidad adecuada (no con incredulidad), con empatía y respeto, pero sin abusar de ellas, permitiendo…”