Doctors may be more concerned about accidentally harming a patient than being sued for malpractice

doctor and nurse look at chart

Linda Isbell was featured in a MedPage Today article citing her recent co-authored paper "Perspectives of emergency clinicians about medical errors resulting in patient harm or malpractice litigation". She discusses results from a survey of Massachusetts clinicians as well as possible interventions to address practitioners who fear harming a patient.

From "Survey Shows ED Doctors Worry More About Patient Harm Than Getting Sued"

Fear of patient harm may be a greater motivator than fear of being sued among emergency department (ED) clinicians making medical decisions, an online survey suggested.

Using a Likert scale of 1 (strongly disagree) to 6 (strongly agree), mean score was 4.40 for fear of harm versus 3.40 for fear of lawsuit (P<0.001) among all ED attending physicians and advanced practice clinicians (APCs) working in Massachusetts acute care hospitals, reported Linda M. Isbell, PhD, of the University of Massachusetts Amherst, and colleagues.

Mean fear-of-harm score was similar whether the survey was completed before or after the COVID-19 pandemic started (4.42 vs 4.39; P=0.70), as was mean fear-of-lawsuit score (3.41 vs 3.38; P=0.70), they wrote in a research letter published in JAMA Network Open.

Fear-of-harm scores were higher than fear-of-lawsuit scores, regardless of clinician type, experience, or sex, and positively correlated (Pearson r = 0.53; P<0.001), the authors said.

These findings challenge interpretations of previous research suggesting that physicians practice "defensive medicine," opting for more tests or providing more referrals to shield themselves from malpractice suits, Isbell and team noted.

"When we look at defensive medicine, a lot of times people are really just focusing on a limited number of variables, and right at the top of the list, everyone thinks that doctors are ordering lots of tests because they're afraid of malpractice," Isbell told MedPage Today. "And we're saying, actually, you can imagine a doctor who is just really afraid of harming people -- a lot of doctors are -- and they don't care that much about malpractice."

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