Shapiro R S, Simpson D E, Lawrence S L, Talsky A M, Sobocinski K A, Schiedermayer D L
Center for the Study of Bioethics Medical College of Wisconsin, Milwaukee.
Arch Intern Med. 1989 Oct;149(10):2190-6.
To systematically assess the impact of malpractice litigation on the doctor-patient relationship and to collect data that might suggest effective tort reform, we surveyed 642 sued physicians, nonsued physicians, and suing patients in Wisconsin. Parallel forms of survey instruments obtained information regarding changes in physicians' practices, changes in attitudes toward patients or physicians, and changes in physical and emotional well-being as a result of malpractice litigation or the threat of the same. In addition, opinions regarding causes and deterrents of malpractice litigation were obtained. Results suggested that claims or threats of malpractice suits had a negative impact on physicians' practices and emotional well-being; that this negative impact was more pronounced when the sued physician had been more personally involved with his patient prior to the malpractice claim; and that suing patients' and sued physicians' understanding of their relationship before the malpractice claim significantly differed. All respondents viewed improved physician-patient communication as the most effective method of preventing malpractice claims. Informal, alternative dispute resolution mechanisms in hospitals and clinics and improved peer review may decrease litigation and its deleterious effects.
为了系统评估医疗事故诉讼对医患关系的影响，并收集可能有助于有效侵权改革的数据，我们对威斯康星州的642名被起诉医生、未被起诉医生和起诉患者进行了调查。平行形式的调查问卷获取了有关医生执业变化、对患者或医生态度的变化以及因医疗事故诉讼或其威胁导致的身心健康变化的信息。此外，还获取了关于医疗事故诉讼原因和威慑因素的意见。结果表明，医疗事故诉讼的索赔或威胁对医生的执业和情绪健康有负面影响；当被起诉医生在医疗事故索赔之前与患者有更多个人接触时，这种负面影响更为明显；并且起诉患者和被起诉医生在医疗事故索赔之前对他们关系的理解存在显著差异。所有受访者都认为改善医患沟通是预防医疗事故索赔的最有效方法。医院和诊所的非正式替代争议解决机制以及改进的同行评审可能会减少诉讼及其有害影响。
