Are the poor more likely to sue their doctors?

Many physicians, including myself, have the misconception that the indigent patient is more likely to be litigious than those patients with greater financial resources.  A well-organized study that was reported in Clinical Orthopeaedics and Related Research reported that socioeconomically disadvantaged patients tend to sue physicians less often than their more affluent patients.

Dr. Ramon Jimenez and his colleagues at the Monterey Orthopaedic and Sports Medicine Institute and his team demonstrated that patients in the lower socioeconomic strata tend to sue doctors less often than those with more income.

Many physicians believe that low-income patients tend to sue their doctors more often than other patients.  This mindset has potential negative effects on the doctor-patient relationship, including some physicians’ reluctance to treat poor patients, or treat such patient differently from other patients groups in medical care terms.

Dr. Jimenez and his colleagues reviewed medical and social studies looking at the differences in litigation rates, and related medical malpractice claims, among socioeconomically disadvantaged patients compared with other groups of patients.  Their analyses show that low-income patients actually sue their doctors less often than other patient groups, in part because of a more limited access to legal resources and a payment system in medical malpractice claims, which requires an advance on funds to litigate the case.

The authors also highlight how physicians may have an unconscious desire to avoid treating poor patients out of concerns about financial reimbursement.  Such physicians might consciously or unconsciously presume that poor patients are more likely to sue, as an excuse or way of avoiding the presumed difficulty associated with collecting payment from low-income patients.  In this situation, the doctor’s unconscious mind can trick him or her into behaving in an undesirable way – a process known as unconscious bias.

Dr. Jimenez suggest that doctors should understand the cultural differences and be able to treat or relate better to a patient from different race, ethnicity, sex, socio-economic status or sexual orientation may help overcome their misperceptions.  In addition improving education and training for the delivery of culturally competent care, and empowering patients to play a more meaningful roles in their healthcare decisions are proven strategies that can positively impact health disparities, the quality of medical care, physician satisfaction and decrease the incidence of medical malpractice litigation.

Bottom Line:  Let’s be a doctor to all patients and not discriminate to those who have less ability to pay for our services.  They are not likely to litigate against us.

Neil Baum is a urologist at Touro Infirmary and author of Marketing Your Clinical Practices: Ethically, Effectively, Economically. He can be reached at his self-titled site, Neil Baum, MDor on Facebook and Twitter.

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