Research finds physicians worry affected person hurt greater than authorized motion as results of medical error

November 21, 2022

2 min learn

Disclosures:
Ostrovsky stories receiving grant funding from the Company for Healthcare Analysis and High quality.


ED attending physicians and superior apply clinicians had a larger worry of affected person hurt than authorized motion within the occasion of a medical error, a current examine discovered.

“Malpractice litigation is a serious concern when medical errors lead to adversarial affected person outcomes,” Daniel Ostrovsky, BMedSc, of the Soroka Scientific Analysis Heart at Ben-Gurion College of the Negev in Israel, and colleagues wrote in JAMA Community Open. “Worry of malpractice has been related to extreme well being care use by defensive medication, whereby further testing or referrals are made to guard physicians from malpractice accusations.”

PC1122Ostrovsky_Graphic_01_WEB
Information derived from: Ostrovsky D, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.41461.

The researchers famous that earlier research have examined how authorized issues influence clinician decision-making, however issues relating to affected person hurt is much less documented, “which is perhaps a stronger impetus for extreme testing.”

In keeping with StatPearls, round 400,000 hospitalized sufferers expertise some sort of preventable hurt every year. In the meantime, 40,000 to 60,000 sufferers expertise dying or harm as a result of missed analysis, with one in 1,000 main care visits resulting in preventable harm.

For the examine, Ostrovsky and colleagues surveyed 1,222 ED attending physicians and superior apply clinicians (imply age, 43 years; 54.2% males) from January 2020 to September 2020.

The respondents used a Likert scale of 1 (strongly disagree) to six (strongly agree) to point their settlement of:

  • how fearful they’re of creating a mistake that ends in hurt to the affected person throughout their day-to-day apply; and
  • how fearful they’re of creating a mistake that ends in being sued.

Ostrovsky and colleagues discovered that the imply rating for worry of hurt was larger than the worry of apply litigation (4.4 vs. 3.4), with modal responses for worry of hurt being “reasonably agree” in contrast with “barely agree” for worry of swimsuit (31.1% vs. 29.1%).

Imply worry of hurt scores earlier than the COVID-19 pandemic had been just like these after the pandemic (4.42 vs. 4.39), which was moreover the case with worry of swimsuit (3.41 earlier than vs. 3.38 after).

When imply worry of hurt scores had been adjusted in multivariable linear regressions, the researchers reported variations between respondents with 5 to 14 years of expertise (P = .009) and 15 to 44 years of expertise (P < .001) vs. these with 0 to 4 years’ expertise, and variations between male vs. feminine respondents (P = .03).

Ostrovsky and colleagues famous that the findings are related to defensive medication, and distinction with earlier research that implied worry of lawsuit was the driving think about extreme testing.

“Though the examine didn’t delineate the affiliation between this concern and potential overuse of testing, it prompt that worry of hurt must be thought-about with, and could also be extra consequential than, worry of swimsuit in medical decision-making,” they wrote, recommending additional analysis to find out the function each fears play in decision-making.

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