Physicians and Medical Malpractice: Why do Doctors have Unwarranted Fears?
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abstract
Physicians are concerned about medical malpractice. Research has shown that physicians remain concerned even when they practice in states that have enacted tort reform measures such as caps on non-economic damages. To understand how doctors in a state with tort-reform (Texas) understood and dealt with their medical malpractice concerns, thirteen semi-structured interviews were conducted and analyzed (six obstetrics/gynecology physicians and seven internal medicine physicians). Research question one explored specifically how Texas doctors make sense of medical malpractice in Texas and their coping strategies. Coding and analysis revealed four dominant themes: 1) legal knowledge (tort reform and legal system); 2) personal risk assessment (not worried vs. its on my mind, heightened concerns, and out of my control); 3) risk reduction techniques (communication skills, patient management skills, and documentation skills); and 4) coping mechanisms (feeling insulated and admitting limitations). The second research question asked physicians to identify sources that influenced their medical malpractice knowledge. They cited the following influences: 1) memorable personal experiences, 2) medical training and experience, 3) information from external organizations, 4) information from unspecified sources. The study confirmed that the participants were still worried about medical malpractice even though they were practicing in state with tort reform. The study also demonstrated that the doctors knowledge of medical malpractice came from their personal experiences and word-of-mouth rather than any formal training or legal resources. The theoretical concepts of legal consciousness and sensemaking were combined in this study to determine how the doctors oriented themselves in relationship to the law and how they came to these positions. By using the theories of legal consciousness and sensemaking together, a contribution is made to current and future scholarship regarding understanding and mitigating doctors concerns regarding medical malpractice.
