It’s not surprising that 70 percent of respondents to the Gallup poll ranked physicians as “highly” or “very highly” honest and ethical, considering that those who were polled are also patients who put their lives in physicians’ hands.
In medical malpractice cases, we see the patients/plaintiffs who have been injured (allegedly) by their physicians. Typically, the reasons why patients sue are based in part on their interactions with their physicians. Therefore, we instruct our clients during deposition and trial preparation that when they testify, they need to keep the “3 Cs” in mind: caring, competent and compassionate. The “3 Cs” should also be used in the daily practice of medicine; physicians who do so can help themselves avoid future medical malpractice claims.
In the world of medicine, caring is described as a “good bedside manner.” Plaintiffs frequently testify that their physicians were not caring because they did not spend enough time with patients, explaining their medical issues. We see this most often in post-operative situations, where there are complications that are not fully explained to the patient. Reaching out to the family members (allowed under HIPAA) in addition to speaking with the patient can increase the perception of being a “caring” physician and could help avoid litigation. In some cases, litigation is unavoidable; therefore, if the physician reaches out to the patient or family, physicians should make a note in the chart that the discussions occurred. Three years later, when the physician is testifying, those notes will certainly bolster the perception of a “caring” physician.
Generally, physicians are perceived to be competent based on their years of education and training. Being able to educate the jury is always a quality that we like to demonstrate during trial. There is nothing more effective than turning page-by-page through the medical record with the doctor on the stand and having him or her explain what every notation in the chart means and the medicine behind it. One of the best complements we have received from jurors after trial is, “I want your client as my physician.” Competence translated into daily practice includes “teaching” the patient about their medical condition and encouraging questions and answering them in layman’s terms. It also means being “honest” about unknown areas of medicine or complications that occur. Spending time with the patient to demonstrate competence while caring for the patient may be the best way to demonstrate competence to a jury three years later.
Unlike “caring,” compassion rarely comes into play when there has been a mistake or complication. There is a tendency in today’s litigious climate to avoid showing compassion to patients when there is a concern over medical malpractice. In some circumstances, a medical malpractice suit is inevitable, while in others, showing compassion to the patient can save the patient’s perception of the physician. In many states, there are “apology” statutes that permit sympathetic conversations to be introduced into evidence. When a complication arises, conversations with risk management and the physician should address how to show compassion to the patient. After all, compassion, as much as medicine, can help heal the patient.
The ranking of 70 percent for “honest and ethical” for physicians is great for the profession. Using the “3 Cs” can go a long way toward enhancing the perception of physicians, especially when mistakes and complications arise.