De-escalating Doctor-Patient Conflict

Posted By Mike Meyer, Tuesday, October 6, 2020

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By Jeff Segal, MD, JD, ByrdAdatto and Medical Justice

Most doctors wake up every morning intending to do the best possible job. Of course, doctors take care of patients. Not all patients are ecstatic about their outcomes. Sometimes this unhappiness morphs into conflict. Conflict is basic to the human condition. If a doctor takes care of 1,000 patients, even if 999 are happy, that one remaining dissatisfied patient may create a headache which will occupy 99% of the doctor's brain space.

That patient may yell at the doctor—in private or in front of other patients. That patient may write a nasty letter. The patient may demand a refund. They may go to small claims court. They may slam the doctor online or complain to the board of medicine. Finally, that patient may find a lawyer to file a lawsuit.

Practicing medicine is hard enough. Trying to deflect a rare, but stressful medico-legal misadventure is enough to make one reconsider a career choice.

Medical Justice was created in 2002 (during the most recent cyclical professional liability crisis) to keep doctors from being sued for frivolous reasons. At the time. It was difficult to find professional liability insurance that was affordable, or, in some cases, even available. Professional liability crises have cycled through almost every 20 years. We are due for the next upswing.

Medical Justice initially focused on holding unethical attorneys and unscrupulous expert witnesses accountable. It addresses countersuits and counterclaims against proponents of such suits in a number of different venues. Since, then Medical Justice has worked with more than 12,000 doctors to de-escalate conflict, often before it devolves into litigation.

Here's a question that perplexes many plaintiff's attorneys; I hear it all the time: Why do doctors take medical malpractice so personally?

Why do doctors treat medical malpractice differently than being in an auto accident? Shouldn't we just turn it over to our carriers and be done with it? I don't think myself the worst driver if I get into a fender bender—I just turn it over to my auto insurer.

The reason: The two systems have little in common.

First, a med-mal lawsuit is packaged as an assault on your reputation. If you doubt that statement, just read the typical cut-and-paste summons. It often includes language such as "with willful and wanton neglect," and so on. It's never couched in language such as "you are a talented doctor who made a mistake. We understand you are human and care deeply about your patients. But, with Mr. Smith, the injury has cost him lost wages and future medical costs."

Next, the subtext is that you will be tried by 12 laypersons who know little about medical care, and your future will be tied to a theatrical battle of experts lasting about four to five years. And the outcome might very well cost more than policy limits, putting your entire nest egg at risk for ruin.

You will spend a great deal of time preparing for and in depositions—time you could be earning revenue and taking care of patients.

You are told not to talk about the case. It's stressful to hold matters such as this inside.

You will learn that medical malpractice settlements and judgments correlate more with the amount of injury as opposed to likelihood of negligence. In other words, death, stroke or the loss of a limb equal a high likelihood of payout.

You will have to explain your record every time you apply for licensing and privileges.

Settlements and judgments now appear on many state licensing board websites.

Settlement and judgments are posted in the National Practitioner Data Bank.

You may hear an expert deliver testimony that has never been uttered before. And a jury might find his delivery credible and compelling.

Against admonitions from a judge, jurors might visit various doctor rating sites to see what other patients think of you. Do they rate you as an arrogant, uncaring person who never listens? Or do they say they are thankful you got out of bed at 2 a.m. to save their mother? Think this doesn't impact a jury's decision? I think it does.

If you are a doctor in a high-risk specialty, there is a 99% chance you will be sued over your career.

So, I close where I began. Most doctors take a medical malpractice lawsuit personally for good reasons. I'm more surprised plaintiff's attorneys are surprised.

While the number of venues patients have to vent their anger has multiplied over the past two decades, so have the solutions we have brought to the table. When the Internet became a platform to rate doctors, we developed the eMerit platform to protect and preserve a doctor's most precious asset—his or her reputation. We made it easy to capture patient feedback so that the voices of all patients were heard—not just the ones shouting the loudest. In that way, a doctor would be defined by a critical mass of patients, not just the angry two with megaphones.

Medical Justice has served doctors as the trusted advocate for the profession. Doctor-patient conflict is inevitable. Preventing or addressing such conflict head-on is what Medical Justice has done for almost two decades.

Jeffrey J. Segal, MD, JD, is the founder and CEO of Medical Justice and eMerit, the online review platform behind Medical Justice. eMerit captures patient feedback and gets it automatically uploaded to the dominant review sites. eMerit also captures patient feedback at the point of service for upload. Your practice can also collect surveys via text message, email, and a survey link integrated into your existing EMR systems.

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