Malpractice Vs. Poor Patient Outcome
Side Note: Mistakes happen and there are actual cases of med mal. However, a lot of the time, as I’m sure you know, patients, or patients’ families, confuse poor outcomes for malpractice. This is because, unfortunately, we live in a culture today that demands that there is always someone to blame. It always has to be someone’s fault. And, in addition to having someone to blame, our society also demands accountability. And so, our culture also has us believe that we have to make that person pay –literally and figuratively, in the form of a med mal lawsuit. But, what can physicians do to lessen the need to place blame, if there is simply a poor outcome (and not an error)?
The answer is simple and not-so-simple. Create a good doctor-patient relationship based on communication. We have all heard this before: open and active communication creates trust. What does this mean and what should the physician do? First, do not assume that because information is given, that it has been received or understood. Patients may be hearing a diagnosis or new language for the first time and are just trying to adjust to the new information. A patient may be stuck on the first new bit of information, and not able to digest the additional new facts you subsequently gave him or her. That is why it is critical to give information in small chunks and check frequently for understanding and ask the patient if they have any questions often.
Also, open communication allows the physician to manage expectations –both the expectations of treatment and the possible road ahead and the patient’s overall expectations for him or herself ahead as a person. Often, the details of treatment that are important to patients aren’t just what the medication is and how often to take it, but information on how treatment will impact their day-to-day life. Often, it is helpful to tell the patient information that puts the information in context, like, “You may want to take it easy the first few days. Most patients don’t feel like themselves while adjusting to treatment.” Or, “Many patients experience diarrhea with this treatment. You may want to stay close to home until you know how this medication will affect you.” While this kind of information is not necessary for the physician to give, it is extremely helpful and lets the patient know that the physician understands that they are not just a patient, but someone trying to live his or her life. Often, it is this kind of information that is really appreciated and ingratiates the physician to the patient. Thus, more trust is built.
In addition, Dr. Warren suggests several small, easy-to-do, actions that often speak volumes to patients. First, he suggests shaking the patient’s hand. Second, he suggests sitting down when taking the patient’s history because this implies that the physician is not in a hurry (even if he or she is). Finally, physicians should look their patients in the eye because this conveys sincerity –it makes the patient feel like they are being heard and that they have their physician’s full attention.
Hopefully these few, easy suggestions will help further reduce your risk for med mal lawsuits.
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Patients, doctors need to have a good relationship
By Dr. Michael Warren
The Daily News
Published February 1, 2011 at www.galvestondailynews.com
Last week, we discussed the rising cost of health care related to malpractice insurance and malpractice lawsuits.
In this column, I would like to discuss the question, “What can we do about this problem?”