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At least 721 records · Page 40Linked to original sources
PubMed2005

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

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.

Adult↗
PubMed1993

Breast cancer malpractice litigation in New York State.

PURPOSE: To identify causes of purported malpractice in diagnosis and treatment of breast cancer. MATERIALS AND METHODS: The authors reviewed cases from The New York Jury Verdict Reporter listed between 1985 and 1991 to look for those in which there was alleged delay in diagnosis or treatment of breast cancer. RESULTS: Of 34 cases identified, 32 (94%) were based on presumed delay in diagnosis and only two (6%) on claims of therapeutic malpractice. Delay in diagnosis was commonly claimed in patients younger than 50 years (76%). Palpable masses were present in 94% of these cases. Either mammograms were not obtained (16 cases, 50%) or findings were interpreted as normal or as fibrocystic disease (12 cases, 38%). Specialists most frequently cited were gynecologists (16 of 39,41%). Highest awards (> or = $1 million) were more commonly given to patients younger than 50 years with proved distant or nodal metastasis (six of 34, 18%). CONCLUSION: Emphasis on early diagnosis has led to the perception that purported delay in diagnosis, however short, even in the presence of a palpable mass, changes the chances for survival.

Adult↗
PubMed1986

How to write a psychiatric report for litigation following a personal injury.

Psychiatrists are frequently asked to assess the psychiatric complications of personal injury cases for individuals who are seeking damages from third parties as the result of an accident. A selective review of the literature concerning the etiology and diagnoses applicable to psychiatric morbidity following personal injury is summarized. The author presents one outline of the medical-legal consultation. The reasons for inclusion of each category of information are discussed, and practical suggestions are made on how the data can be interpreted and used to educate the judicial system about the emotional consequences of accidents.

Consultants↗