Poor patients less likely to sue physicians

Although some of your low-income patients may struggle financially, they are less likely to sue you for medical malpractice, according to an analysis of claims and studies.

The study, published in Clinical Orthopaedics and Related Research by Ramon L. Jimenez, MD, an orthopedic surgeon from the Monterey Orthopaedic and Sports Medicine Institute, suggests that the perception that socioeconomically disadvantaged patients are more litigious may exist because of doctors’ subconscious prejudices or stereotypes.

Jimenez and his team cite a 1995 survey of primary care physicians in California showing that half of the physicians didn’t treat Medicaid or uninsured patients because of a perceived greater lawsuit risk. The authors reviewed medical and social studies comparing litigation rates and medical malpractice claims among low-income patients. They found that Medicaid patients sue doctors less often or at the same rate as non-Medicaid insured patients.

The authors contend that low-income patients sue less frequently due to limited access to legal resources. Medical malpractice claims typically require advance payment to take a case to court.

The researchers also argue that culturally competent care is an effective means to overcome unconscious bias. For example, many patients perceive that they are not treated appropriately, or with respect, because of mistakes made by providers who are not familiar with their culture, according to Jimenez. They can, as a result, turn away from the healthcare system, resulting in disparities in care.

“Helping doctors to become more culturally competent, i.e. able to treat or relate better to a patient from a different race, ethnicity, sex, socio-economic status or sexual orientation, may help overcome these misperceptions,” Jimenez said in a statement. “In addition, improving education and training for the delivery of culturally competent care, and empowering patients to play more meaningful roles in their healthcare decisions are proven strategies that can positively impact health disparities, the quality of medical care, physician satisfaction, and the incidence of medical malpractice litigation.”

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