Document Detail

Do fears of malpractice litigation influence teaching behaviors?
MedLine Citation:
PMID:  18615293     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Medical malpractice is prominently positioned in the consciousness of American physicians, and the perceived threat of malpractice litigation may push physicians to practice defensively and alter their teaching behaviors. PURPOSE: The purposes of this study were to characterize the attitudes of academic medical faculty toward malpractice litigation and to identify teaching behaviors associated with fear of malpractice litigation. METHODS: We surveyed 270 full-time clinically active physicians in the Department of Medicine at a large academic medical center. The survey assessed physicians' attitudes toward malpractice issues, fear of malpractice litigation, and self-reported teaching behaviors associated with concerns about litigation. RESULTS: Two hundred and fifteen physicians responded (80%). Faculty scored an average of 25.5 +/- 6.9 (range = 6-42, higher scores indicate greater fear) on a reliable malpractice fear scale. Younger age (Spearman's rho = 0.19, p = .02) and greater time spent in clinical activities (rho = 0.26, p < .001) were correlated with higher scores on the Malpractice Fear Scale. Faculty reported that because of the perceived prevalence of lawsuits and claims made against physicians, they spend more time writing clinical notes for patients seen by learners (74%), give learners less autonomy in patient care (44%), and limit opportunities for learners to perform clinical procedures (32%) and deliver bad news to patients (33%). Faculty with higher levels of fear on the Malpractice Fear Scale were more likely to report changing their teaching behaviors because of this perceived threat (rho = 0.38, p < .001). CONCLUSIONS: Physicians report changes in teaching behaviors because of concerns about malpractice litigation. Although concerns about malpractice may promote increased supervision and positive role modeling, they may also limit important educational opportunities for learners. These results may serve to heighten awareness to the fact that teaching behaviors and decisions may be influenced by the malpractice climate.
Darcy A Reed; Donna M Windish; Rachel B Levine; Steven J Kravet; Leah Wolfe; Scott M Wright
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Teaching and learning in medicine     Volume:  20     ISSN:  1532-8015     ISO Abbreviation:  Teach Learn Med     Publication Date:    2008 Jul-Sep
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8910884     Medline TA:  Teach Learn Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  205-11     Citation Subset:  IM    
Division of Primary Care Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
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MeSH Terms
Cross-Sectional Studies
Defensive Medicine
Education, Medical / trends
Faculty, Medical
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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