Patients often sue for reasons that have nothing to do with the quality of the medical care rendered, but rather for the human care that is perceived as lacking.
The last few weeks were very difficult for my family and friends in the medical sense. I had one family member in an intensive care unit on the West Coast, one friend’s father in a rehab facility on the East Coast, and one friend’s son having problems in the outpatient setting in the Midwest. These patients are male and female, young and old, and have very different medical histories, but they all have one thing in common. They all want to sue about their medical care or lack thereof. These cases illustrate three common reasons you might get sued, so let’s take a closer look at what has gone wrong for each patient.
Reason One: Poor Communication
A family member casually mentioned that she was having a routine procedure at the hospital, which she expected to take the afternoon. I did not give it much thought because she is generally young and healthy. The next thing I heard was that she had undergone a coronary artery bypass graft (CABG) and was on life support with a dubious prognosis. Of course, we were all shocked and quickly rallied around her.
She remained in that state for the next 13 days before things started looking up. Obviously, I have shortened this story, but she is now home in a much weakened condition with a long period of disability and recuperation ahead of her. When I visited, I asked the obvious questions about exactly what happened and why. She said she also asked those questions to multiple team members, but she did not get any satisfactory answers from anyone. She truly did not understand anything about her condition or even what surgery she had. I might add she is educated and quite capable of understanding.
She proclaimed that she probably would have to sue to find out exactly what happened. This is clearly the wrong conclusion. Why would a patient have to sue as a communication method? Surely there are far better, less expensive places to converse with patients and their families than in court. The patient, the hospital, and the physicians all would truly benefit from a patient liaison, who would clearly explain everything and answer every single question until all parties were satisfied.
Reason Two: Perception of Lack of Caring
On the opposite coast, a friend is battling with a rehab center on behalf of her elderly father. She has recounted incident after incident to me that leave her feeling frustrated and angry. For example, she noticed he had lower extremity swelling and asked if her dad should wear compression stockings. The nurse agreed that it was good idea and said she would proceed in obtaining both the physician order and the stockings. My friend’s question to me was a simple one—didn’t the staff notice his legs were swollen? Why did she, a layperson, have to intercede? Aren’t they supposed to take care of him?
Four days later, she asked her father about the stockings. He said he never got them and his feet were so swollen he could not even wear slippers or participate in his physical therapy because of “these tree trunks.”
Simply put, my friend was mad. She rhetorically asked me to explain why it takes 4 days to get a simple pair of compression stockings. On the next visit, she confronted the director of nursing (DON), who in turn confronted the floor nurse. The floor nurse said she thought she had to order them, and the DON replied that they have plenty in the stockroom as she casually grabbed a pair. My exasperated friend said her father could have had the stockings all week if they cared. Many similar incidents ensued, including problems with sleep medication, sleeping schedules, transport to the hospital, and therapy. My friend concluded her story by saying that she told the DON if things did not improve, she would have no choice but to sue.
Again, this is not a good outcome for anyone involved. We have to show caring and concern for our patients. Only a hard look at the individual situation will determine if the problem is burnout, staffing levels, lack of training, poor systems, or a combination of these or other factors. The bottom line is any perceived lack of caring may lead to litigation because families are counting on us to know our job and do it with empathy.
Reason Three: Lack of Trust
My friend’s son had a stress test that revealed some cardiac abnormalities. The doctor recommended more invasive cardiac testing, but her son refused to agree to the tests. My friend enlisted my help to convince him that he needed to submit to further testing.
I spoke to him at length and explained the test and exactly what would happen. I probed and probed trying to figure out why he would not agree. It finally came out that he did not trust the doctor and felt the doctor was trying to increase his own revenue by making him get “a whole bunch of tests.” Her son explained that this is how he thought doctors make more money. He remarked that he should sue the doctor to expose the doctor’s “scheme.” After much explanation, I convinced him that this was certainly not the case, and eventually he scheduled the tests he clearly needed.
When patient-doctor trust is broken, it is very hard to repair. I have no idea what broke their trust, but it probably is something that has nothing to do with the actual medical care. Quite often it is a poorly managed office that causes problems or some rushed communication.
Lessons to Learn These are three brief glimpses into what is happening with real patients in the real world. Litigation is on everyone’s mind and something easily grasped for leverage in a situation where people feel they have no control. Litigation is rampant, not because of poor medical care but because of poor human care. Every single day, patients tell me the doctor rushed them, the facility was dirty, the healthcare professional typed into the electronic record the entire visit and did not even look at them, and they cannot get the proper paperwork or the appointments they need. They generally are disappointed and frustrated. I think we all went into healthcare because we want to help people, so please make your goal this week to communicate, care, and earn the trust of your patients.