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www.RxForSanity.com ,[object Object],[object Object],[object Object]
The Rude Get Sued Patricia L. Raymond MD FACP FACG Florida Society for Healthcare Risk Management & Patient Safety 3 August 2007
“… if a doctor shall operate on the eye of a man with a copper lancet and that man shall lose his eye, the eye of the doctor with a copper lancet they shall put out, and if he operated on a wound and the patient die, his hand is to be cut off...”   ~Code of Hammurabi, 3000 BC
 
 
Who’s to blame for malpractice suits? Medical Economics, July 1999
“ Human behavior just doesn't change unless there are significant adverse consequences for unscrupulous behavior. When justice does prevail (and often it does not) the price of righteousness has to be high to prevent continued transgression.” The Burton Report www.burtonreport.com/infforensic/MedMalTortReform  Lawyers:  Defense of  Righteousness?
 
 
Effects of malpractice on HCPs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why do MDs get sued? We’re RUDE…
 
Why do docs get sued? ,[object Object],[object Object],[object Object],[object Object],[object Object],The Lancet.  1994;343:1609-1613.
“ It isn’t medical outcome.  A patient is more willing to forgive the physician for a poor outcome if there was good communication to begin with.”
Is your doctor in a hurry? ,[object Object],[object Object]
Association between  number of patient complaints and  ‘risk management events’ ,[object Object],[object Object],[object Object],[object Object],JAMA June 12, 2002
71% of malpractice suits (are) filed based on a breakdown of the physician-patient relationship. Howard Beckman MD, 1994
 
The Medical Apology ,[object Object],[object Object],[object Object],[object Object]
 
Disclosure ,[object Object],[object Object],Witman AB, Arch Int Med 1996;156:2565-2569.
 
Full vs. Partial Disclosure ,[object Object],[object Object],Ann Int Med 2004;140:409-418
Full vs. Partial Disclosure ,[object Object],[object Object],[object Object],Ann Int Med 2004;140:409-418
 
Tap dancing, anyone? ,[object Object],[object Object]
Tap dancing, anyone? II ,[object Object],[object Object]
Fall on your sword ,[object Object],[object Object]
Fall on your sword II ,[object Object],[object Object]
Fall on your sword III ,[object Object]
 
Full vs. Partial Disclosure ,[object Object],[object Object],[object Object],[object Object],[object Object],Ann Int Med 2004;140:409-418
Patients Seek Legal Advice Seeking legal advise is only stat more likely for allergy/non -serious/non -disclosure
Juries may not understand the medicine,  but all have experienced rudeness.
Exacerbated by ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Explain IQ verses EQ   Daniel Goleman, Working with Emotional Intelligence, 1998
 
Poor collegial relationship between physicians and nurses ,[object Object],[object Object],[object Object],[object Object],Rosenstein, AJN 2002
 
Why should we care? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why should we care? ,[object Object],[object Object]
Incivility and morbidity/mortality ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why should we care? ,[object Object],[object Object],[object Object]
 
Health literacy issues ,[object Object],[object Object],[object Object],[object Object],1998 AMA  study on low health literacy
 
“ Patients want their physician to help them restore balance and control over their lives, not to treat them with an impersonal or condescending attitude.  Lawsuits are launched by patients who blame poor outcome on a perceived lack of professionalism on the part of the physician.” ~Richard Bernard, SCPIE/American Healthcare Indemnity
Rx: Teach your docs  bedside manners
 
 
 
 
EQ 101 for the physician ,[object Object],[object Object],[object Object],[object Object],[object Object]
1. “Be gracious” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],gracious
2a. Ask patients to assist with their own care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physicians with no history of malpractice claims ,[object Object],[object Object],[object Object],Levinson W, JAMA 1997;277:553-559.
Can you hear me? ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Patients on the Net ,[object Object],[object Object],[object Object],Journal of Medical Internet Research  (2003;5(3):e17)
2b. Help your docs partner with medical colleagues ,[object Object],[object Object],[object Object],[object Object]
 
Nobody wants constructive criticism.  It's all we can do to put up with constructive praise.  -- Mignon McLaughlin Fish Compl
 
Help your docs learn to express gratitude/ positive reinforcement ,[object Object],[object Object]
[object Object]
Rude by proxy: Our office staff “ Sarcasm is just one more service that we offer.”
Customer service ,[object Object],[object Object],[object Object],[object Object]
 
 
3.Help your docs learn to apologize ,[object Object],[object Object],[object Object],[object Object],[object Object],Ann Int Med 2004;140:409-418
 
How??? ,[object Object],[object Object],[object Object]
4. Expect your docs to be nice to their/your lawyer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
If your docs choose to be rude… The Doctors Wealth Protection Guide,  Mandell DB, Goldstein AS, Jarvis CR.    1999 Guardian Publishing
Few things are harder to put up with than a good example. -Mark Twain 1835-1910
Teach your docs to play nice. I 3 Implement it immediately!
 
www.RxForSanity.com ,[object Object],[object Object],[object Object]

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The Rude Get Sued

  • 1.
  • 2. The Rude Get Sued Patricia L. Raymond MD FACP FACG Florida Society for Healthcare Risk Management & Patient Safety 3 August 2007
  • 3. “… if a doctor shall operate on the eye of a man with a copper lancet and that man shall lose his eye, the eye of the doctor with a copper lancet they shall put out, and if he operated on a wound and the patient die, his hand is to be cut off...” ~Code of Hammurabi, 3000 BC
  • 4.  
  • 5.  
  • 6. Who’s to blame for malpractice suits? Medical Economics, July 1999
  • 7. “ Human behavior just doesn't change unless there are significant adverse consequences for unscrupulous behavior. When justice does prevail (and often it does not) the price of righteousness has to be high to prevent continued transgression.” The Burton Report www.burtonreport.com/infforensic/MedMalTortReform Lawyers: Defense of Righteousness?
  • 8.  
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  • 10.
  • 11. Why do MDs get sued? We’re RUDE…
  • 12.  
  • 13.
  • 14. “ It isn’t medical outcome. A patient is more willing to forgive the physician for a poor outcome if there was good communication to begin with.”
  • 15.
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  • 17. 71% of malpractice suits (are) filed based on a breakdown of the physician-patient relationship. Howard Beckman MD, 1994
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  • 33. Patients Seek Legal Advice Seeking legal advise is only stat more likely for allergy/non -serious/non -disclosure
  • 34. Juries may not understand the medicine, but all have experienced rudeness.
  • 35.
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  • 44.
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  • 46.
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  • 48. “ Patients want their physician to help them restore balance and control over their lives, not to treat them with an impersonal or condescending attitude. Lawsuits are launched by patients who blame poor outcome on a perceived lack of professionalism on the part of the physician.” ~Richard Bernard, SCPIE/American Healthcare Indemnity
  • 49. Rx: Teach your docs bedside manners
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  • 63. Nobody wants constructive criticism. It's all we can do to put up with constructive praise.  -- Mignon McLaughlin Fish Compl
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  • 67. Rude by proxy: Our office staff “ Sarcasm is just one more service that we offer.”
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  • 76. If your docs choose to be rude… The Doctors Wealth Protection Guide, Mandell DB, Goldstein AS, Jarvis CR.  1999 Guardian Publishing
  • 77. Few things are harder to put up with than a good example. -Mark Twain 1835-1910
  • 78. Teach your docs to play nice. I 3 Implement it immediately!
  • 79.  
  • 80.