Healthcare practitioners are highly trusted and respected professionals, yet their human fallibility raises essential questions about the consequences of failing to meet professional standards of practice.
By David Martin, B.A.
Key Takeaways
Exploring the history of medical malpractice
Explaining its prevalence and how serious of a problem it is
Describing some of the causes and contributing factors of medical malpractice
Providing future insights into how best to combat medical malpractice and hold doctors accountable
Introduction
As a society, we come to hold healthcare practitioners in high esteem. They treat us when we are ill, prescribe us medication so that we can feel better, and tend to our physical and mental health needs. We trust their knowledge and judgment when it comes to managing our health. In fact, according to an Ipsos poll, medical doctors are the most trusted profession in the United States and worldwide. Recent Gallup poll results also reveal that medical doctors and other healthcare professionals, like nurses, are some of the most highly revered professions in the United States (see Figure 1). But physicians, being human, can sometimes err. So, what are the deleterious consequences when medical practitioners fail to meet professional standards of practice?
A Personal Anecdote
Not too long ago, my younger brother relayed his recent experience during a trip to the dentist’s office. The dentist had determined that he had cavities on his wisdom teeth, so she recommended he have them surgically extracted. My brother, feeling hesitant, inquired as to whether there could be an alternative, safer solution, such as a filling, to which she curtly dismissed his concerns by responding with, “Do you have a degree in dentistry?”. She then tried to instill fear in him by advising him that he could receive a filling from another dentist who could potentially damage his teeth or put his life at risk.
My brother, still weary of getting his teeth extracted, set out to gain a second opinion from another dentist. The second dentist, this time successfully filling his wisdom tooth, informed him that some dentists try to push expensive procedures, like wisdom teeth extraction, to bill patients’ insurance companies more money. This story highlights that differing perspectives among healthcare providers can sometimes underlie different motivations, some of which may not be ethical or in the patient’s best interest. Yet some, like the first dentist who treated my brother, still operate under the outdated belief that the “doctor is always right.”
History of the Legality of Medical Malpractice
First, briefly exploring the history behind the laws governing medical conduct is helpful. When it first became a distinct discipline, medical science saw heavy regulation since the dawn of recorded human history. Medicine emerged in the ancient Near East during the second millennium BC, and along with it came doctor and patient rights and responsibilities. Penal codes for medical malpractice during those times were particularly severe.
For instance, in ancient Babylon, the Code of Hammurabi dictated criminal and civil law, including medical liability. The penalty for a doctor inadvertently killing a patient during surgery would include having their hands amputated. In ancient Egypt, physicians who failed to adhere to scientific standards faced possible execution, regardless of their successful operations. Roman law was more nuanced: upper-class physicians were exiled when they were found guilty of misconduct, while lower-class physicians were sentenced to death.
During the 12th century CE, Roman law eventually influenced English common law, which, in turn, later impacted the United States’ medical malpractice legislation centuries later. The United States’ understanding of medical malpractice falls under the legal framework of tort law, which encompasses violations such as professional negligence and intentional harm. In the 19th century, the US brought attention to medical malpractice claims.
These claims significantly surged during the 1960s when legal barriers to lawsuits were removed, new healthcare treatments were introduced, and rapidly changing public attitudes towards the healthcare system quickly were changing. This has led medical professionals to lobby for federal and state laws to protect them from potential injury lawsuits in subsequent decades. During the COVID-19 pandemic, doctors actively lobbied policymakers to protect them from lawsuits since staff shortages and financial constraints caused them to work outside their specialties.
So Why is it a Major Issue that Deserves Scrutiny?
Doctors' decisions often become a matter of life and death for the patient, and faulty decision-making can spell disastrous results. According to Johns Hopkins Medicine, medical errors in the US account for 795,000 deaths or permanent disability each year. That is enough people to populate a large city. These errors, whether surgical errors, misdiagnoses, wrong prescriptions, or negligence, jeopardize the patient’s well-being and safety.
Causes Behind Medical Malpractice
Why is medical malpractice prevalent? Carefully examining this phenomenon can shed light on many contributing factors. To comprehend this trend fully, consider these various elements:
Misdiagnosis or delayed diagnosis: Sometimes, doctors might misdiagnose a patient’s symptoms or delay diagnosis altogether, which hinders the patient from seeking treatment early. The top three most misdiagnosed conditions are cancer, infectious diseases, and vascular events, which account for 75% of misdiagnosis-related harms.
Surgical Errors: Errors made during surgical operations can be life-threatening. These types of medical errors can encompass anything from retention of foreign body elements, healthcare provider burnout, and mislabeled specimens to wrong-site, wrong-procedure, and wrong-patient errors (WSPEs).
Lack of Training: Sometimes, doctors may not have the necessary training or skills to successfully perform certain operations due to staff shortages, lack of knowledge, or lack of available equipment.
Discrimination: Oftentimes, healthcare providers are not free from biases and preconceived opinions about others based on their membership to a particular demographic group. This can perpetuate unfair and unequal treatment of patients based on characteristics such as ethnicity, race, gender, social class, sexuality, and religion. For instance, numerous studies have attested that women are far less likely than men to be diagnosed and subsequently treated for cardiovascular problems, which stems from the stereotyped belief that heart failure is primarily men’s disease. In fact, according to a nationwide survey, only 22% of primary care physicians and 42% of cardiologists say that they feel adequately prepared to assess cardiovascular risk factors in women.
Cultural or Linguistic Barriers: Cultural and/or linguistic impediments can hinder effective communication between patients and doctors, perpetuating misunderstandings.
Defensive Medicine: The mere threat of a potential malpractice lawsuit has created the term “defensive medicine,” in which a doctor operates under the self-centered belief that their best interest is avoiding a possible lawsuit rather than serving their patients. For example, a doctor might shy away from recommending a surgical procedure that might otherwise save a patient’s life for fear that a mistake could cost them their license.
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Conclusion
Honesty, integrity, accountability, and compassion should be the guiding principles behind any patient-provider interaction. These qualities will serve to minimize the risk of medical errors and retaliation. The purpose of this article is not to malign all medical practitioners but to raise awareness about the significant harm that medical malpractice inflicts and the subsequent loss of trust in the healthcare delivery system as a result. Areas of improvement for future legislation could include reducing defensive medicine, improving medical practice and knowledge, fostering cultural competence and empathy between patients and the healthcare system, and adequately compensating patients should gross negligence and harm occur.
Frequently Asked Questions
What proportion of physicians sued for medical malpractice are found guilty of it?
According to research studies, most doctors who are sued win their cases, with fewer than 10% of cases resulting in a verdict against the doctor.
How can patients safeguard themselves from medical malpractice?
Patients should be familiar with their rights during patient-doctor encounters and be aware of the right to refuse any potentially harmful treatment. A second or even third opinion from other healthcare professionals is advisable. Patients should also keep detailed records of their medical history and treatments and ask questions to thoroughly understand their diagnosis and treatment options.
What legal reforms can effectively reduce medical malpractice and adequately compensate injured parties?
Reforms should address the needs of both patients and clinicians. Fostering transparency and trust between providers and their patients is paramount to reducing harm and litigation. Improvements in the healthcare delivery system, investigative processes, and training can also ensure that patients receive optimum support and care to avoid errors.
What role do insurance companies play in navigating medical malpractice?
Insurance companies generally help healthcare providers, rather than patients themselves, to navigate any potential liability claim against them. This could include providing financial coverage for attorney fees, court costs, and monetary compensation in cases where the doctor is found guilty. This is because health insurance companies can minimize their financial risks and ensure that patients pay their medical bills and premiums.
Sources
Brenan, M., & Jones, J. M. (2024, October 16). Ethics ratings of nearly all professions down in U.S. Gallup.com. https://news.gallup.com/poll/608903/ethics-ratings-nearly-professions-down.aspx
Common medical malpractice insurance policy forms. Gallagher. (2019, March). https://www.gallaghermalpractice.com/resources/introduction-to-medical-malpractice/
Davis, C. (2023, October 4). A better measure of medical error. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/news/articles/2023/10/a-better-measure-of-medical-error
Doctors are the most trusted profession in the U.S. and across the world | ipsos. (2021, October 12). https://www.ipsos.com/en-us/news-polls/global-trustworthy-index-US-version
Guardado, J. R. (n.d.). Medical liability claim frequency among U.S. physicians. https://www.ama-assn.org/system/files/policy-research-perspective-medical-liability-claim-frequency.pdf
Hals, T. (2020, April 2). U.S. doctors on coronavirus frontline seek protection from malpractice suits. https://www.usnews.com/news/us/articles/2020-04-02/us-doctors-on-coronavirus-frontline-seek-protection-from-malpractice-suits
Kass, J. S., & Rose, R. V. (2016, March 1). Medical malpractice reform: Historical approaches, alternative models, and communication and Resolution Programs. Journal of Ethics | American Medical Association. https://journalofethics.ama-assn.org/article/medical-malpractice-reform-historical-approaches-alternative-models-and-communication-and-resolution/2016-03#:~:text=In%20the%20United%20States%2C%20medical,%2C%20among%20others%20%5B19%5D.
Mandilara, P., Galanakos, S. P., & Bablekos, G. (2023, July 9). A history of medical liability: From Ancient Times to today. Cureus. https://pmc.ncbi.nlm.nih.gov/articles/PMC10408696/
Santos, G., & Jones, M. W. (2023, May 29). Prevention of Surgical Errors. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK592394/
Williamson, L. (2024, February 9). The slowly evolving truth about heart disease and women. www.heart.org. https://www.heart.org/en/news/2024/02/09/the-slowly-evolving-truth-about-heart-disease-and-women
Figure 1: Brenan, M., & Jones, J. M. (2024, October 16). Ethics ratings of nearly all professions down in U.S. Gallup.com. https://news.gallup.com/poll/608903/ethics-ratings-nearly-professions-down.aspx
About David Martin, BA
I graduated from the University of Maryland, Baltimore County, with a Bachelor of Arts in Biological Sciences and a Minor in Sociology. I am pursuing my master's in public health with a concentration in epidemiology from Benedictine University. As an aspiring epidemiologist, health researcher, and advocate, I seek to utilize my skills in conducting analytical research to influence health policy decision-making and preventative healthcare to achieve equitable health outcomes for everyone.
