Caring For Patients In A Malpractice Crisis: Physician Satisfaction And Quality Of Care

Abstract

The rhetoric of malpractice reform is at fever pitch, but political advocacy does not necessarily reflect grassroots opinion. To determine whether the ongoing liability crisis has greatly reduced physicians' professional satisfaction, we surveyed specialist physicians in Pennsylvania. We found widespread discontent among physicians practicing in high-liability environments, which seems to be compounded by other financial and administrative pressures. Opinion alone should not determine public policy, but physicians' perceptions matter for two reasons. First, perceptions influence behavior with respect to practice environment and clinical decision making. Second, perceptions influence the physician-patient relationship and the interpersonal quality of care.

Medical Malpractice Reform and Physicians in High‐Risk Specialties

“…This is consistent with their later results (Mello et al 2005) that suggest that Pennsylvania specialists have scaled back their practices and are more likely to retire early as a result of liability exposure. Their results also indicate that this has led to a reduction in access to care for patients in Pennsylvania.…”

“…Taking a different approach, Mello et al (2004) surveyed specialists in Pennsylvania and found that their professional satisfaction is negatively related to liability exposure. This is consistent with their later results (Mello et al 2005) that suggest that Pennsylvania specialists have scaled back their practices and are more likely to retire early as a result of liability exposure.…”

Changes In Physician Supply And Scope Of Practice During A Malpractice Crisis: Evidence From Pennsylvania

“…Other evidence indicates that the impact of the crisis on physicians was considerable, in terms of costs, anxiety, and disillusionment with the practice of medicine. 32 Statewide, however, physicians appear to have held their ranks and weathered this distress.…”

Risk of Malpractice Claims and Changes in Professional Autonomy: A Qualitative Study of Obstetrician-Gynaecologists in Switzerland

“…Patients' complaints are experienced by doctors as a challenge to their expertise and as a potential threat to their professional identity (Marjoribanks et al 1996;Allsop and Mulcahy 1998). Several studies suggested that medical encounters have been deeply altered by a growing litigious environment, since the trusting patient was replaced by a threatening or confrontational patient (Mello et al 2004;Jacques 2007), resulting in strained doctor-patient relationships (Cook and Neff 1994). For example, it has been said that increased physicians' liability degraded the traditional trust-based doctor-patient relationship (Vanderminden and Potter 2010).…”