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Robyn S. Shapiro, JD; Deborah E. Simpson, PhD; Steven L. Lawrence, MD; Anne Marie Talsky; Kathleen A. Sobocinski, MS; David L. Schiedermayer, MD

Arch Intern Med. 1989;149(10):2190-2196.

Abstract
• 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.

(Arch Intern Med. 1989;149:2190-2196)

Author Affiliations
From the Center for the Study of Bioethics (Atty Shapiro, Dr Schiedermayer, and Ms Talsky) and the Departments of Bioethics (Atty Shapiro), Educational Services (Dr Simpson), Family Medicine (Dr Lawrence), Biostatistics (Ms Sobocinski), and Medicine (Dr Schiedermayer), Medical College of Wisconsin, Milwaukee.

Footnotes
Accepted for publication April 14, 1989.

Reprint requests to Center for the Study of Bioethics, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226 (Atty Shapiro).

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