ER Physicians Fear Harming Patients: A common refrain from medical malpractice “reform” advocates who want to place barriers to medical malpractice victims being compensated for the harms they suffered is that emergency department medical staff order unnecessary medical tests, often referred to as “defensive medicine,” because they fear being sued for medical malpractice if they fail to do so.
The results of a study published on November 10, 2022 in JAMA Network entitled “Perspectives of Emergency Clinicians About Medical Errors Resulting in Patient Harm or Malpractice Litigation” concluded: “The findings of this study suggest that, although clinicians feared legal action, they feared harming patients to a greater degree regardless of clinician subtypes, experience, or sex; these findings are relevant to defensive medicine. Some studies implied that fear of lawsuit was the primary factor in excessive testing by physicians. Clinicians were also concerned about preventing patient harm. Although the study did not delineate the association between this concern and potential overuse of testing, it suggested that fear of harm should be considered with, and may be more consequential than, fear of suit in medical decision-making.”
The researchers conducted an online survey targeting all ED attending physicians and advanced practice clinicians (APCs) in acute care hospitals across Massachusetts from January to September 2020. The respondents included 1,222 clinicians (mean [SD] age, 43.3 [10.6] years; 608 men [54.2%], 506 women [45.1%], 8 other gender [0.7%]). The researchers found the response rates were similar for physicians (77.2%) and APCs (75.8%).
Respondents used a Likert scale of 1 (strongly disagree) to 6 (strongly agree) to indicate degree of agreement with 2 statements: “In my day-to-day practice, I am fearful of making a mistake which results in [1] harm to the patient” (fear of harm) and “[2] being sued” (fear of suit). The researchers reported that the mean score was greater for fear of harm than fear of suit (4.40 vs 3.40; P < .001). Mean fear-of-harm score was similar regardless of survey completion before or after the COVID-19 pandemic started (4.42 vs 4.39; P = .70). No difference was found in mean fear-of-suit score before vs after the pandemic started, (3.41 vs 3.38; P = .70).
If you or a loved one suffered harm as a result of emergency room negligence in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your emergency room medical malpractice claim for you and represent you or your loved one in a emergency room malpractice case, if appropriate.
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