An internet television program that explores the intersection of medicine and the law.

Medical Malpractice Claims and the Doctor-Patient Relationship

By Anupam B. Jena, MD, PhD to Defensive Medicine


Medical Malpractice Claims and the Doctor-Patient Relationship

Our guest on Healthcare Matters is Anupam B. Jena, MD, PhD, one of the authors of the study Physician spending and subsequent risks of malpractice claims: an observational study, which was published in The BMJ in November 2015. Dr. Jena sat down with Healthcare Matters to discuss the study's results, methods and limitations as well as its implications for research on defensive medicine and healthcare spending. Dr. Jena details how the study shows a correlation between increases in physician spending and a lower likelihood for that physician to be subsequently sued for malpractice. Though the study has several limitations which are addressed during the interview, it helps to shed light on important aspects of healthcare spending, the doctor-patient relationship and the difference between appropriate healthcare spending and defensive medicine. In Part IV of our interview, we ask Dr. Jena to discuss the role of the doctor-patient relationship in medical malpractice claims. This is the fourth part of our interview with Dr. Jena. To see the full interview, click here. To view each portion of the interview separately, please use the links below.

  1. Does Defensive Medicine "Work"?
  2. Greater use of Resources vs. Defensive Medicine: What's the Difference?
  3. The Link between Physician Spending and Medical Malpractice Claims
  4. Medical Malpractice Claims and the Doctor-Patient Relationship
  5. Physician Spending, Patient Outcomes and Future Research
  6. How can we differentiate between defensive medicine and “good” medicine?
  7. Fee-for-Service vs. Outcome-Based Models and the Effect on Healthcare Costs
  8. Could Defensive Medicine Actually Lower Medical Malpractice Claims?
This interview is brought to you by Cunningham Group, the Medical Malpractice Insurance Specialists.


Mike Matray: Okay. I’d like to drill down and follow up on that, because one of the beliefs within the medical liability community is a lot of times whether a physician faces a claim or not, is dependent upon his or her bedside manner or relationship with a patient. Are you saying that isn’t the case?

Dr. Jena: No, it certainly could be the case, but I think it’s really important to try to bring the best data available to bear on this issue. So that’s a hypothesis that I think has a lot of face validity. I certainly believe it, and I think few would disagree that it’s probably an important mechanism behind why patients sue doctors is the lack of a good relationship. But none the less, at the end of the day, this isn’t a theoretical question, this is an empirical question. So we’ve got to look at the data and say, “Well, what does the data bear out?” And unfortunately, there isn’t a lot of high quality data one way or the other, to support the view that it’s the quality of the relationship between a doctor and a patient that leads to lawsuits.

There is some data, but I wouldn’t call it definitive by any means. And to be fair, I wouldn’t call our own analysis to be definitive. I think what it is, is a first attempt to try to understand whether factors that many doctors argue to be important in driving their liability actually bear on the data.