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Showing content from https://pubmed.ncbi.nlm.nih.gov/15987961/ below:

Does litigation influence medical practice? The influence of community radiologists' medical malpractice perceptions and experience on screening mammography

Multicenter Study

doi: 10.1148/radiol.2361040512. Does litigation influence medical practice? The influence of community radiologists' medical malpractice perceptions and experience on screening mammography

Affiliations

Affiliation

¹ Dept of Internal Medicine, Univ of Washington School of Medicine, Harborview Medical Ctr, 325 Ninth Ave, Box 359780, Seattle, WA 98104-2499, USA. jelmore@u.washington.edu

PMID: 15987961
PMCID: PMC3143020
DOI: 10.1148/radiol.2361040512

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Multicenter Study

Does litigation influence medical practice? The influence of community radiologists' medical malpractice perceptions and experience on screening mammography

Joann G Elmore et al. Radiology. 2005 Jul.

doi: 10.1148/radiol.2361040512. Affiliation

¹ Dept of Internal Medicine, Univ of Washington School of Medicine, Harborview Medical Ctr, 325 Ninth Ave, Box 359780, Seattle, WA 98104-2499, USA. jelmore@u.washington.edu

PMID: 15987961
PMCID: PMC3143020
DOI: 10.1148/radiol.2361040512

Item in Clipboard

Abstract

Purpose: To assess the relationship between radiologists' perception of and experience with medical malpractice and their patient-recall rates in actual community-based clinical settings.

Materials and methods: All study activities were approved by the institutional review boards of the involved institutions, and patient and radiologist informed consent was obtained where necessary. This study was performed in three regions of the United States (Washington, Colorado, and New Hampshire). Radiologists who routinely interpret mammograms completed a mailed survey that included questions on demographic data, practice environment, and medical malpractice. Survey responses were linked to interpretive performance for all screening mammography examinations performed between January 1, 1996, and December 31, 2001. The odds of recall were modeled by using logistic regression analysis based on generalized estimating equations that adjust for study region.

Results: Of 181 eligible radiologists, 139 (76.8%) returned the survey with full consent. The analysis included 124 radiologists who had interpreted a total of 557 143 screening mammograms. Approximately half (64 of 122 [52.4%]) of the radiologists reported a prior malpractice claim, with 18 (14.8%) reporting mammography-related claims. The majority (n = 51 [81.0%]) of the 63 radiologists who responded to a question regarding the degree of stress caused by a medical malpractice claim described the experience as very or extremely stressful. More than three of every four radiologists (ie, 94 [76.4%] of 123) expressed concern about the impact medical malpractice has on mammography practice, with over half (72 [58.5%] of 123) indicating that their concern moderately to greatly increased the number of their recommendations for breast biopsies. Radiologists' estimates of their future malpractice risk were substantially higher than the actual historical risk. Almost one of every three radiologists (43 of 122 [35.3%]) had considered withdrawing from mammogram interpretation because of malpractice concerns. No significant association was found between recall rates and radiologists' experiences or perceptions of medical malpractice.

Conclusion: U.S. radiologists are extremely concerned about medical malpractice and report that this concern affects their recall rates and biopsy recommendations. However, medical malpractice experience and concerns were not associated with recall or false-positive rates. Heightened concern of almost all radiologists may be a key reason that recall rates are higher in the United States than in other countries, but this hypothesis requires further study.

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Figures
Figure 1

Bar graph shows that radiologists…

Figure 1

Bar graph shows that radiologists believed that their peers’ recommendations were more influenced…

Figure 1

Bar graph shows that radiologists believed that their peers’ recommendations were more influenced by malpractice concern than were their own recommendations.

Figure 2

Graph shows no statistically significant…

Figure 2

Graph shows no statistically significant associations between radiologist patient-recall rates and reports of…

Figure 2

Graph shows no statistically significant associations between radiologist patient-recall rates and reports of prior medical malpractice claims. Each data point represents one radiologist, and error bars represent 95% confidence intervals.

Figure 3

Bar graph shows that the…

Figure 3

Bar graph shows that the majority (61%) of radiologists who consider leaving mammography…

Figure 3

Bar graph shows that the majority (61%) of radiologists who consider leaving mammography on a monthly, weekly, or daily basis thought that their probability of being sued in the next 5 years was 50% or higher. Numbers below x-axis, which indicates how often a radiologist considered leaving mammography practice, are numbers of radiologists.

Figure 4

Bar graph shows that, of…

Figure 4

Bar graph shows that, of radiologists who believed that their concerns about malpractice…

Figure 4

Bar graph shows that, of radiologists who believed that their concerns about malpractice greatly increased the number of their recommendations for diagnostic mammography and/or US, the majority (56%) thought that their probability of being sued in the next 5 years was 50% or greater. Numbers below x-axis, which indicates how radiologists characterized the influence of malpractice on the number of their recommendations for diagnostic mammography and/or US, are numbers of radiologists.