One Patient Power reader asked, “I know all doctors pay an insurance premium. I would be interested in knowing if the fear of litigation affects some of the decisions doctors make in the treatment of multiple myeloma.”
Although there’s no single answer to how each individual oncologist manages myeloma or any other cancer, there are some facts you should know about this issue.
Why is Malpractice Such a Big Deal?
Of course, most doctors do pay a premium to stay insured against any medical malpractice lawsuits. There are a variety of reasons why patients would take legal action against their doctors.
According to a 2012 paper published in the New England Journal of Medicine, under 10% of oncologists each year face malpractice claims – a little bit higher than the overall rate of malpractice claims for physicians, but lower than the rate in high-risk specialties like surgery.
What are these claims for? According to a study published in Diagnosis, researchers used a database of malpractice claims to analyze cases between 2006 and 2015. The study found that 34% of malpractice cases for death or permanent disability began with “errant or delayed diagnosis,” making this the biggest cause of serious harms among medical errors. Failures of clinical judgment, rather than communication failures or failing to close the loop on test results, were behind more than 85% of claims for serious harms from misdiagnosis.
If a physician is concerned about litigation, they may perform more testing or suggest more aggressive treatment than they otherwise would consider. In a National Bureau of Economic Research analysis, researchers found evidence that doctors do practice “defensive medicine,” defined as tests and procedures performed to protect against lawsuits. They showed that doctors spent 5% less in an inpatient setting on care when they were immune to liability, with no detriment to patient outcomes.
Doctors Follow Guidelines
Legally, your provider should not be performing any procedures or tests that aren’t required for your condition. “The law is that any healthcare provider, including a hospital, is only negligent if they practice medicine below the standard of care in the community,” said Thomas A. Demetrio, Esq., a partner with Corby & Demetrio in Chicago. “If a test is required under the standard of care, it should be given. If not, it shouldn’t be.”
Clinical guidelines help physicians determine what treatments are considered standard care. They summarize the latest medical knowledge, present the pros and cons of both procedures and treatments, and provide evidence-based recommendations to the doctor. They’re also updated regularly.
However, these guidelines are not legally binding, so your doctor doesn’t have to follow these recommendations if they have reason to believe they are not suitable for your case. But your doctor will have to justify their rationale.
Seek Second Opinions When Concerned
Lastly, it’s important to remember that you, the patient, have the final say in whether you want to undergo any tests or treatments during your myeloma journey. If your doctor ever suggests a treatment that you don’t want or that you question, you should get a second opinion (or even a third).
Thomas A. Demetrio, Esq. reported no disclosures.