Second victim: Malpractice disputes and quality of life among primary care physicians

Abstract

Purpose: The health of physicians can have a strong impact on the quality and safety of the health care they provide. Studies have shown a link between work stress, burnout, and depression. The aim of this study was to examine the association between malpractice dispute experiences and the well-being of physicians. Methods: We conducted a cross-sectional survey to collect information about the malpractice experiences of primary care physicians in 2004. Data on sociodemographic and clinical characteristics and SF-36 measures were also collected. We used propensity score matching to estimate the association of medical malpractice experience with the general health, mental health, and vitality of physicians. Results: Among the 1206 primary care physicians who completed the survey (response rate of 13.4%), 25.2% reported having ever experienced a malpractice dispute. After adjustment for baseline variables, physicians who had experienced a malpractice dispute had significantly worse health-related quality of life with regard to general health [−4.85; 95% confidence interval (CI), −7.61 to −1.80; P = 0.0016], mental health (−2.68; 95% CI, −5.03 to −0.34; P = 0.0252), and vitality (−3.28; 95% CI, −6.10 to −0.47; P = 0.0224). The effects were particularly strong among physicians specializing in surgery or obstetrics and gynecology. Conclusion: The results reveal that a malpractice dispute can have a long-term negative effect on the health of physicians. Harm reduction programs for physicians involved in malpractice disputes should be implemented. Keywords: Health-related quality of life, Medical malpractice, Physician, Propensity score matching