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Good rapport with patients helps lessen lawsuit risk


When you spend a lot of time talking with patients in the office, you may wonder how you will finish all the work related to diagnosis and treatment on any given day, but many good reasons exist for these conversations.

Patients tend not to sue doctors whom they like. The biggest factor that leads patients to sue is a potentially large financial award stemming from a bad medical result. The second most important factor, however, is that the patient is angry and/or dissatisfied. A patient with whom you have poor rapport may view a bad result as your fault, whereas a satisfied patient may perceive a bad result as an unfortunate result of a particular treatment.


Patients who sue their physicians typically say that a doctor didn't treat them right and did not communicate with them. In one study of real malpractice cases, patients interviewed at their depositions reported feeling abandoned, not being heard, and not being given information.

We know that poor communication can lead to lawsuits, but it is difficult to demonstrate that good communication can prevent them.

A Harvard study conducted an analysis of all hospital admissions in New York state for a fixed time period. The researchers identified 1,133 adverse events out of 30,000 admissions. Medical reviewers determined that 280 of these events were caused by negligence. These events represent potential malpractice claims.

The researchers then identified 47 lawsuits out of the total hospital admissions. Eight of the lawsuits met the definition of medical malpractice. The remaining 39 may or may not have been related to negligence.

One conclusion often drawn from this study is that a great number of nonmeritorious cases end up in the legal system. Another important conclusion to be derived from the study, however, is that many potentially meritorious cases do not end up in the legal system at all. If eight cases are in the legal system out of 280 adverse events caused by negligence, that leaves 272 potential plaintiffs who never sued. Perhaps there were no damages, or perhaps the patients never went to plaintiffs' attorneys because they liked their physicians.


Some doctors whose medical skills are suspect are sued less frequently than doctors with high medical skill levels because they have great rapport with patients. Conversely, some highly competent doctors are sued more frequently than their peers. A high level of medical skill is not always a defense against a lawsuit. Good communication may be an effective defense.

Physician education about documentation has been very successful. Medical recordkeeping has improved over the years. It is much more difficult to improve communication skills. Why? You developed your communication style during medical school, internship, and residency. It is ingrained in you. It may be easier to write a better note than it is to learn how to better relate to your patients.

Communication may be the best risk management tool available to you in stopping lawsuits before they happen, however, so pay careful attention to building rapport with your patients.

In the January 25 column, I'll offer specific tips to help you improve communication with your patients.

The author is a health law attorney in Mt. Kisco, New York, and a Medical Economics consultant. Malpractice Consult deals with questions on common professional liability issues. Unfortunately, we cannot offer specific legal advice. If you have a general question or a topic you would like to see covered here, please send it to medec@advanstar.com

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