Study identifies doctors most likely to get sued

Anna Samecki

2/06/2022 4:46:44 PM

An Australian-first study has found ‘unhappy and overworked’ doctors are more likely to be sued compared to ‘agreeable’ colleagues.

Stressed doctor.
Medicolegal advisor Dr Sara Bird says good communication and contemporaneous notes are key in reducing the risk of litigation.

Among the other findings, published today in the British Medical Journal, are that doctors who had suffered a recent injury or illness, worked in rural areas, or who were older, male and performed surgical procedures, were also more likely to have a medical negligence claim brought against them.
The study, led by Dr Owen Bradfield and Professor Matthew Spittal from the University of Melbourne, analysed responses from more than 12,000 Australian doctors to the Medicine in Australia Balancing Employment and Life (MABEL) survey between 2013 and 2018.
Just over 5% of the doctors surveyed reported being named in a medical negligence claim during the study period, with the findings more pronounced for male doctors than female.
Speaking with newsGP, MDA National medicolegal advisor, Dr Sara Bird, said the results are in keeping with previous studies that have associated an increased risk of claims with poor communication, such as rudeness, failure to give information and a lack of interest.
‘Some [previous] studies have suggested that up to 70% of claims are related to poor communication,’ Dr Bird said.
‘This fits with the observation in the study that an “agreeable” personality was protective of claims.
‘The vast majority of GPs are excellent communicators, and the challenge is to maintain this level of communication when they are feeling overworked, dissatisfied or unwell.’
The latest findings come at a time where GPs face mounting financial and workforce pressures in light of unsustainable Medicare rebates and an ongoing global pandemic.
GP Dr Paresh Dawda knows all too well the pressures of general practice.
He says there are steps that GPs can take on an individual, as well as practice level, to help reduce their risk of patient safety incidents, negligence claims and burnout more generally.
On an individual level, Dr Dawda says self-awareness and reflection are really important and suggests having a good framework for this, such as the ‘three bucket model’.
‘I think the way we schedule appointments can also help,’ he told newsGP
‘As we see patients throughout the morning or afternoon, we are likely to get increasingly fatigued and that affects our decision making.
‘Either introducing breaks or having rotation of tasks or types of appointments, such as a change from normal consultations to procedures or telehealth, may help.’
Dr Dawda’s other tips include working with – and seeking support from – your team, as well as debriefing and ‘having a chat with colleagues’ when able.
His advice is echoed by Dr Bird.
‘I think this is reflected in the study, which suggests an increase in the risk of being sued in doctors who were overworked, had low life satisfaction and a recent serious personal injury or illness,’ she said.
Her main advice for reducing litigation risk is good communication.
‘The patients of those doctors who were more likely to be sued thought they were rushed by their doctor, had less time spent with them, received no explanations and felt ignored,’ Dr Bird said.
‘My other key tip to reduce your risk of being sued is to make good clinical notes.
‘This is not only invaluable in defending any allegations against a doctor in a potential claim, but it is also of great assistance in ensuring continuity of patient care and handover, especially in multi-doctor practices and part-time GPs.’
A summary of all Dr Bird’s tips can be found below.
Key strategies to reduce litigation risk:

  • Pay close attention to the quality of communication and doctor-patient interactions
  • Make good clinical notes
  • Look after your own health and wellbeing 
  • Address any unrealistic patient expectations
  • Manage any adverse events with compassion and use open disclosure principles
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A.Prof Christopher David Hogan   3/06/2022 10:52:38 AM

Owen Bradfield is a colleague & I congratulate him & Prof Spittal on their work.
This work reinforces the advice I was given as a student in the 1970s & the anecdotal experience of many MDOs ever since.
Anecdotes are one thing , hard evidence is another.
People become upset when their perception of what is happening does not match their expectations.

A.Prof Christopher David Hogan   3/06/2022 10:54:56 AM

People become upset when their perception of what is happening does not match their expectations.
Sadly the abysmal level of Health Literacy in the population (currently 41%) means their expectations of a medical encounter are often inappropriate.
We must be respected if we are to do our job.
We ask intrusive & intimate questions, We do intimate & intrusive examinations. Our treatments are often painful & invasive. We ask people to do difficult alterations to their lifestyle & adhere to disruptive treatment regimens.

If we are to earn this respect, we must explore their expectations, correct their misconceptions & give them proper advice. We must also explain what to do if things do not go as expected.
This takes time. We cannot afford this if we do Universal Bulk Billing
The rebate on patient fees from Medicare is too low.

Dr Chi-Hui Pam Yin   4/06/2022 6:47:39 AM

I am interested to know if the authors of the study were contacted to make comments. I believe Dr Bradfield is also a General Practitioner and a member of RACGP.