Happy patients less litigious

Primary care physicians who spend time with their patients, talking with them, listening to them, and laughing with them may reduce the risk of being sued for malpractice, according to a study in the Feb. 19 issue of theJournal of the American Medical Association.

The study draws a connection between bedside manner and the likelihood of being sued for malpractice and those who rush their patients through a visit. Researchers audiotaped at least 10 routine patient visits, each with 59 primary care physicians and 65 general and orthopedic surgeons in Colorado and Oregon.

Different communication styles

Subjects were randomly selected and were divided into two groups depending on their malpractice claims history. The 1,265 audiotapes were analyzed by coders who did not know whether the physicians fit into the "claims" or "no claims" group. The study found significant differences in communication styles between primary care physicians who had been filed against and those who had not.

Primary care physicians in the no claims group spent an average of 18.3 minutes with patients during a routine office visit; those in the claims group spent an average of 15 minutes.

Researchers also found that primary care physicians in the no claims group were more likely to use explanations such as, "First I’m going to examine you, and then we will talk the problem over." These physicians also asked patients for their opinions, elicited questions, and were more likely to use humor and laugh during an office visit.

The researchers concluded that "physicians can incorporate these behaviors into routine practice to improve their communication skills and decrease their malpractice risks."

The study was funded by the Agency for Health Care Policy and Research and led by Wendy Levinson, MD, formerly of Oregon Health Sciences University and Legacy Good Samaritan Hospital and Medical Center in Portland, OR. She now is the chief of the section of internal medicine at the University of Chicago.