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• W4220794583 abstract "Dear Dr Dermatoethicist: I witnessed a dermatologist querying a patient if they were going to file a malpractice lawsuit against another dermatologist who missed their melanoma. Is it ethical to encourage a patient to take legal action?—Concerned Resident Dear Dr Dermatoethicist: I witnessed a dermatologist querying a patient if they were going to file a malpractice lawsuit against another dermatologist who missed their melanoma. Is it ethical to encourage a patient to take legal action? —Concerned Resident Dear Concerned Resident: The American Medical Association reported that 1 in 3 physicians are sued by the age of 55 years.1O'Reilly K.B. 1 in 3 physicians has been sued; by age 55, 1 in 2 hit with suit.https://www.ama-assn.org/practice-management/sustainability/1-3-physicians-has-been-sued-age-55-1-2-hit-suitDate accessed: February 13, 2022Google Scholar In a study of 45 malpractice suits, health care professionals were found to have encouraged patients to sue 54% of the time.2Beckman H.B. Markakis K.M. Suchman A.L. Frankel R.M. The doctor-patient relationship and malpractice: lessons from plaintiff depositions.Arch Intern Med. 1994; 154: 1365-1370Google Scholar Researchers interviewed patients seeking legal counsel and reported that 27% of the patients pursued legal remedies based on their physician’s advice.3Huycke L.I. Huycke M.M. Characteristics of potential plaintiffs in malpractice litigation.Ann Intern Med. 1994; 120: 792-798Google Scholar A missed diagnosis does not necessarily signify medical malpractice, which causes injury or harm to a patient due to falling below the standard of medical care (ie, performing unlike what a “reasonable” physician would have) by executing an error in diagnosis, treatment, or surgery. Even though the most common claim in malpractice cases is a delay in diagnosis, diagnostic errors in cancer have been reported to approach 13.5%.4Newman-Toker D.E. Wang Z. Zhu Y. et al.Rate of diagnostic errors and serious misdiagnosis-related harms for major vascular events, infections, and cancers: toward a national incidence estimate using the “Big Three”.Diagnosis (Berl). 2020; 8: 67-84Google Scholar Early neoplasms often lack diagnostic features, making an accurate diagnosis impossible until the conditions evolve. Unless you were present at the visit with the preceding dermatologist, you do not know how the lesion initially presented. There are innumerable potential motivating factors for a consulting physician to encourage their patient to sue. Even if the physician is acting in good faith and invokes the principle of beneficence on behalf of the patient, consider the patient’s right to self-determination without interference from others (autonomy), which was violated in this example. In a study of 14,700 cases of negligence, 97% of the patients did not sue the physicians who were responsible for their injury5Studdert D.M. Thomas E.J. Burstin H.R. Zbar B.I. Orav E.J. Brennan T.A. Negligent care and malpractice claiming behavior in Utah and Colorado.Med Care. 2000; 38: 250-260Google Scholar; either the patients wanted to file lawsuits but decided that the benefits did not outweigh the costs, or they simply did not wish to sue. Therefore, what 1 physician may perceive as wrong or negligent may not be viewed similarly by the patient. The patient may view the mistake as a sincere error, an act deserving forgiveness, or malpractice. The decision to sue should be generated by the patient as an act of reparation (financially and/or emotionally) and to prevent future errors or the decision to not sue as an act worthy of forgiveness. Lawsuits are emotionally traumatizing, demoralizing, expensive, and time consuming for both the patient and the accused physician. Respecting the patient’s autonomy, it is not ethical to encourage legal action. If we know that a physician is a repeat outlier in the quality of care delivered to their patients, there are other ways to approach this situation. Even for an outlier physician, we strongly recommend against a doctor discussing the case with the patient prior to informing the authorities. Involving local medical societies and state medical boards may help to prevent future errors. These societies could consider investigating and performing a root cause analysis, the results of which would then be discussed with the physician. Helping patients seek justice against what is perceived by another physician as wrongdoing should be replaced by encouraging the patient to weigh the benefits and costs of different paths to pursue. — Dr Dermatoethicist None disclosed." @default.
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• W4220794583 title "Ethics of encouraging a malpractice lawsuit against a dermatologist colleague" @default.
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