One of the greatest problems that healthcare providers face is a failure to communicate. In several malpractice lawsuits, patients have claimed that their physician didn’t properly communicate the potential risks and benefits of a screening test or procedure. Therefore, the patient was unable to make an informed decision as to whether or not they should have the test. Simply following the guidelines of an agency, such as the U.S. Preventative Services Task Force, isn’t enough to remove all liability from the provider.
The importance of communication was demonstrated by a 2007 study discussed in an article from Medical Economics. This study, published in the Journal of Law, Medicine & Ethics, presented potential jurors with a hypothetical lawsuit. A 49-year-old patient went in for a checkup and was examined for any minor problems. The patient had no urinary tract symptoms, no family history of prostate cancer, and was considered part of a high-risk group for prostate cancer. The patient returned the following year for another checkup. There were no obvious changes to his symptoms or family history and the physician opted to not order a PSA test. Two years later, the patient was seen by another physician who ordered a PSA test. The patient was diagnosed with aggressive prostate cancer.
In this hypothetical case, the patient sued his original provider, claiming that if he had been better informed about the test then he would have requested a PSA test during his checkup. If the PSA test had been ordered then the cancer may have been curable. The original physician testified that he often discussed the benefits and risks of the test with patients over 50 and that this routine met the recommendations of his professional organization. When the potential jurors were given this scenario, approximately 83% felt that the standard of care was breached.
The same scenario was given once more, but with two new elements introduced. In this case, the physician documented in the medical record that there was discussion with the patient about the benefits and risks of the PSA test, but the patient chose to decline the test. These two factors had a major influence on the outcome of the malpractice case. 72% of potential jurors now agreed that the physician had met the standard of care.
Interestingly, when a video aid, “Is a PSA Test Right for You?” was shown to the patient, approximately 94% believed that the physician met the standard of care. This video succeeded in educating the jurors on the decision to have a PSA test and it documented the content that was provided for the patient. The jurors found that the use of tools demonstrated that the physician went to significant lengths to ensure that the patient understood the PSA test.
It’s crucial that physicians communicate with their patients. They need to discuss the pros and cons of procedures and tests, documenting these discussions in their medical records. It’s also highly recommended that technological aids are used to ensure that the patient thoroughly understands the test or procedure and can make an informed decision.
Author: Lauren Daniels