Are you the compliant, uninformed low income patient the AMA and lawyers are targeting?

How doctors can spot patients likely to sue

Knowing what types of patients are more lawsuit prone can help reduce physicians’ liability risks.

By ALICIA GALLEGOS, amednews staff. Posted Feb. 4, 2013.  (FiDA editing and highlight-this is a compilation of quotes only-please read full story on link above)

Lower-income people are less likely to sue their doctor than wealthier patients.  probably because of lack of access to legal resources, according to  a May 2012 study in Clinical Orthopaedics and Related Research

“There are individuals in society where it doesn’t matter what happens to them; they’re going to look the other way,” said Gerald B. Hickson, MD, director of the Center for Patient and Professional Advocacy at Vanderbilt University School of Medicine in Nashville, Tenn. 

People who have higher social statuses, live in urban areas and have higher education also are more likely to file claims, Sacopulos said. Another contributing factor is whether the patient personally knows a doctor or attorney, adds Mark Horgan, senior vice president for claims at CRICO, a professional medical liability insurer in Massachusetts.

 If people beg for a procedure or demand treatments, that should raise a red flag, said Dr. Scherger, co-contributor of a 2011 video presentation called “The Legal Risk Patient” posted on the website of QuantiaMD, an online physician learning collaborative.  Medical liability defense attorney Michael J. Sacopulos  She complained about nearly every doctor she had seen previously.

“Now more than ever before, patients are well-informed, 

 Potential indications of a suit include receiving a subpoena or a request for medical records, or experiencing an unexpected or unfortunate outcome in which a patient is upset.

65% of medical liability lawsuits are dropped, dismissed or withdrawn. 

[Illustration by Gilbert Ford / www.gilbertford.com]

just under a quarter resulted in settlements. Of the 8% that went to trial, 90% of those claims ended in a doctor’s favor, the AMA analysis showed.

In 2011, the average expense payment was $49,756, an increase of 5% from 2010. Expense payments include bills paid to attorneys, expert witnesses and other defense costs. A January study in Health Affairs found that the average physician spends nearly 11% of his or her career with an unresolved medical liability claim.

“I don’t think the majority of lawsuits are filed because the patient is litigious, but 

“The trouble is if a lawsuit is ever filed, the doctor has that on their record, even if the case is dismissed.”

said Sacopulos, chief executive officer for the Medical Risk Institute in Terre Haute, Ind. The institute counsels health professionals on understanding and reducing litigation risks.

“You don’t really know what the circumstances were, and that patient may have had every reason to sue, but if it’s happened more than once, that would concern me,” he said. “Before I would refuse a patient, I would talk to my risk manager or insurance company.”

“I’m not saying, I want medical professionals to maintain a code of silence, but 

The ethics of parting ways

If a patient continues to be dissatisfied with a physician, it may be time to end the relationship,

American Medical Association ethical policy states that a physician is under both ethical and legal obligations to provide services as long as a patient needs them. A termination generally should be communicated verbally to the patient and with a letter outlining the reasons for the dissolution, the policy says.

ADDITIONAL INFORMATION: 

How to address legally risky patients

Doctors should use caution when treating patients they believe may sue. Being open and communicative with such patients can reduce liability risks and help build stronger relationships.

Document. Carefully document patient conversations, treatments and clinical evaluations.

Use secure communication. Encourage secure online communication with the patient so documentation is recorded on both sides and stories cannot be changed later.

Build trust. Focus on getting to know the patient and developing trust with him or her.

Be transparent. Be open with the patient and clearly explain all medical treatments and diagnoses.

Encourage inquires. Invite the patient to ask questions, and answer all concerns honestly.

Say you’re sorry. Apologize to the patient and take responsibility for any mishaps when appropriate.

Source: “The Legal Risk Patient,” QuantiaMD, 2011

WEBLINK

“Do Poor People Sue Doctors More Frequently? Confronting Unconscious Bias and the Role of Cultural Competency,” Clinical Orthopaedics and Related Research, May 2012 (www.ncbi.nlm.nih.gov/pubmed/22367624/)

“On Average, Physicians Spend Nearly 11 Percent Of Their 40-Year Careers With An Open, Unresolved Malpractice Claim,” Health Affairs, January (content.healthaffairs.org/content/32/1/111)

“Professional Liability Insurance Indemnity and Expense Payments, Claim Disposition, and Policy Limits, 2002-2011,” American Medical Association, December 2012, for AMA members only (www.ama-assn.org/resources/doc/health-policy/x-ama/prp2012-03piaa.pdf)