I’ve written before about medical malpractice and the rising costs for physicians of all specialties. One of the things we as physicians really fear is malpractice lawsuits by patients. We are taught in medical school and in training that the number one way to prevent a lawsuit is to talk to the patient and address their concerns. If a mistake is made, it is best to come forward in advance and let the patient know that a mistake was made. Perhaps the mistake was made by the physician, perhaps by the hospital, perhaps by another physician that the patient previously saw. Usually an apology will prevent a lawsuit.

Physicians all take an oath to do no harm and to always do what is best for the patient. Unfortunately, patients do not take an oath to protect their physicians from harm. Thus there are times when a physician does the right thing but an untoward outcome still results. Some illnesses and diseases and procedures are not “cure-alls” and the patient must know this in advance.

When things to escalate and a patient files a malpractice lawsuit, it is generally easier and cheaper for the physician to settle the claim out of court. The cost of settlement usually is far less than the cost of litigation for lawyers and for time spent. Additionally, the mental stress of an ongoing lawsuit can be disruptive both to professional and personal life for the physician.

One effect of settling claims outside of court is that they go on your record. When a patient looks up your public record, he or she can see that you settled a claim. Additionally, when you go to renew your malpractice insurance, your premiums will increase. Sometimes, it will prohibit you from renewal because you are considered “high-risk”.

Studies have shown that patients who ultimately file a lawsuit are looking for something from the physician. Usually it is time and attention and not money. Unfortunately, money typically is the solution when it gets to that point. Unfortunately, given that the system is set up so that physicians settle out of court, the physician can be penalized by frivolous claims.

Some people think that such is the risk we take to serve others as physicians. Others suggest that there needs to be reform. I’m not exactly sure what the answer is, but one side effect of this messed up system is that physicians become very picky about who they accept as patients. If someone appears to be litigious or very high maintenance then a physician may defer care to another physician in order to reduce risk. In an elective situation, this is probably not that big of a deal. In an emergent situation, it can be life threatening.