Cutting through the myth of malpractice lawsuits

"Excuse me, Mr. David, it is very critical that you keep your mouth wide open," said the muffled voice of Dr. Omar behind a white mask and transparent shield. "We are almost done here, I will just use this small rotating disk to polish up your front teeth to get you that beautiful white smile you always wanted." Dr. Omar said to comfort his patient, who has been keeping his mouth open for almost 30 minutes. Mr. David has become too comfortable to that point of being drowsy and falling asleep—in the dental chair. (comfort goals)

Dr. Omar continued with the final touches of the freshly contoured front row of beautiful pearl white teeth up-until... Mr. David snoozed again and unintentionally closed his lips together to abruptly meet the rotating sharp polishing disk.

ZAP The disk cut right through Mr. David's lip as a knife cuts through butter.

⚠️ Disclaimer: The story below was the response I received from Dr. Omar (pseudonym) when I inquired during our interview about the most challenging situation he encountered with a patient. 

Caution - There will be blood 🩸

"It happened so fast...the split lips, the blood and Mr. David widely opening his eyes and mouth in surprise and confusion." recalled Dr. Omar with a sad facial expression

"Luckily Mr. David's lips were numb from the anesthetic injection 💉so he felt no physical pain per se." Dr. Omar continued, "But his eyes were laser-focused on mine—-fishing for answers from my half-covered face 😷. I still remember how hard I was trying to keep a calm and collected demeanor—while hearing my heart pounding in my ears."

With shaking yet intentional hands, Dr. Omar swiftly grabbed a cotton gauze from the side tray and firmly held the injured lips in efforts to slow down the bleeding...while simultaneously signaling in the calmest tone of voice possible to his dental assistant to grab the suturing kit from the small white cabinet in the far end of the room.

"I need you to hold still Mr. David, the disk has cut through your lips and we need to stop the bleeding and fast. Luckily it was not a tremendously deep cut, but we still need about 3 stitches to sew up the cut. It will all be okay Mr. David." it was at that moment, Dr. Omar knew he would have some explaining to do afterward—not just to his patient but to authorities for the up-coming malpractice lawsuit. 👨🏻‍⚖️

What a terrible situation to be in! Yet what happened next in Dr. Omar's story was shocking and not logical...

As soon as all was done, Dr. Omar apologetically said to Mr. David that he was sorry it turned out this way. But with an oozing sutured lip, Mr. David got out of the dental chair and replied: "I apologize for dozing off Doctor, you warned me many times, you were trying to do your job and I had to do mine...It's unfortunate this happened, but honestly, I am thankful this happened with you. I respected and trusted you before the incident and now I respect and trust you, even more, when I saw how professionally you handled this unexpected situation."

You probably guessed it by now... Dr. Omar did not get sued. As a matter of fact, Mr. David and his family are now among his most regular patients to this day.

I was puzzled after the interview and kept wondering whether Dr. Omar just got lucky with a super understanding patient or was there more to this situation than the eye can see? (assuming he was truthful and all)

There is only one way to find out...let's dive into the research and analyze malpractice lawsuits!

The Research

It was interesting to see that multiple published studies have shown that the risk of getting sued could not be predicted by patient characteristics (Mr. David being understanding or not!), illness complexity (Hollywood smile VS knee surgery), or even physicians' technical skills (Dr. Omar's many years of experience). 1,2

Instead, the risk of getting sued was related to patients' dissatisfaction with their physicians' ability to establish rapport, provide access, administer care and treatment consistent with expectations, and communicate effectively. 3,4,5

OR in Dr. Omar's case "Excuse me, Mr. David, it is very critical that you keep your mouth wide open" and even after the incident happened "I need you to hold still Mr. David, the disk has cut through your lips and we need to stop the bleeding and fast...It will all be okay Mr. David."

Clearly something else is at play here, so how about the actual lawsuits that have been filed against doctors?

Malpractice Lawsuits

Believe it or not, the risk of being sued for malpractice has very little to do with how many mistakes a doctor makes. Analyses of malpractice lawsuits show that there are highly skilled doctors who get sued a lot and doctors who make lots of mistakes and never get sued. At the same time, the overwhelming number of people who suffer an injury due to the negligence of a doctor never file a malpractice suit at all (not insinuating that Dr. Omar was negligent). In other words, patients don’t file lawsuits because they’ve been harmed by shoddy medical care. Patients file lawsuits because they’ve been harmed by shoddy medical care and something else happens to them.

What is that something else? It’s how they were treated, on a personal level, by their doctor. What comes up again and again in malpractice cases is that patients say they were rushed or ignored or treated poorly. “People just don’t sue doctors they like,” is how Alice Burkin, a leading medical malpractice lawyer, puts it.

“In all the years I’ve been in this business, I’ve never had a potential client walk in and say, ‘I really like this doctor, and I feel terrible about doing it, but I want to sue him.’ We’ve had people come in saying they want to sue some specialist, and we’ll say, ‘We don’t think that doctor was negligent. We think it’s your primary care doctor who was at fault.’ And the client will say, ‘I don’t care what she did. I love her, and I’m not suing her.’”

Burkin once had a client who had a breast tumor that wasn’t spotted until it had metastasized, and she wanted to sue her internist for the delayed diagnosis. In fact, it was her radiologist who was potentially at fault. But the client was adamant. She wanted to sue the internist. “In our first meeting, she told me she hated this doctor because she never took the time to talk to her and never asked about her other symptoms,” Burkin said. “‘She never looked at me as a whole person,’ the patient told us…. When a patient has a bad medical result, the doctor has to take the time to explain what happened, and to answer the patient’s questions — to treat him like a human being. The doctors who don’t are the ones who get sued.” It isn’t necessary, then, to know much about how a surgeon operates in order to know his likelihood of being sued. What you need to understand is the relationship between that doctor and his patients.”

It's so interesting to see that Burkin's statements tie in strongly with existing published literature (check out the excerpt below 👇)

"Patients who saw physicians with the highest numbers of lawsuits were more likely to complain that their physicians would not listen or return telephone calls, were rude, and did not show respect." 6,

The Verdict

It seems that both published research and analyses of malpractice lawsuits point towards problems with communication, humaneness, and clinical care. It makes us consider how patients actually feel about "the way" they are treated during a clinical visit. Indeed, a slice of butter thinner than the untrained eye can see.

Mr. David walked away from the encounter feeling that his doctor respected him as an individual and treated him like family. If you think about it, why else would he refer his own family to Dr. Omar?

Case Closed!

Note to reader: This article is part of a series on demystifying healthcare experiences. You can read my previous article here 👉🏽 This is going to hurt

Please feel free to share your thoughts in the comment section below.