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Gerald B. Hickson, MD; Ellen Wright Clayton, MD, JD; Stephen S. Entman, MD; Cynthia S. Miller; Penny B. Githens, MS; Kathryn Whetten-Goldstein, PhD, MPH; Frank A. Sloan, PhD

JAMA. 1994;272(20):1583-1587.

Abstract
Objective.
—To examine the relationship between prior physician malpractice experience and patients' satisfaction with care.

Design.
—Women were interviewed using a questionnaire that contained structured and open-ended questions.

Participants.
—Mothers of all stillborn infants, infant deaths, and a random sampling of viable infants drawn from 1987 Florida Vital Statistics were sorted into four groups based on the malpractice claims experience of their obstetricians between 1983 and 1986. Interviews were completed with 963 of 1536 women, most by telephone, 53 by in-person interview.

Main Outcome Measures.
—Mothers' responses to closed-ended and open-ended questions about their perceptions of the care they received during their pregnancy, labor, and delivery.

Results.
—Even though none of the women actually filed a claim, a consistent pattern of differences emerged when comparing women's perceptions of care received. Patients seeing physicians with the most frequent numbers of claims but without high payments were significantly more likely to complain that they felt rushed, never received explanations for tests, and were ignored. In response to the open-ended question, "What part of your care were you least satisfied with?" women seeing physicians in the High Frequency malpractice risk group offered twice as many complaints as those seeing physicians who had never been sued. Problems with physician-patient communication were the most commonly offered complaints.

Conclusion.
—Physicians who have been sued frequently are more often the objects of complaints about the interpersonal care they provide even by their patients who do not sue.

(JAMA. 1994;272:1583-1587)

Author Affiliations
From the Division of General Pediatrics, Departments of Pediatrics (Drs Hickson and Clayton and Ms Miller) and Obstetrics and Gynecology (Dr Entman), Vanderbilt University School of Medicine and School of Law (Dr Clayton) and Institute for Public Policy Studies (Drs Hickson, Clayton, Entman, and Sloan and Ms Githens), Vanderbilt University, Nashville, Tenn, and Center for Health Policy Research and Education, Duke University, Durham, NC (Dr Whetten-Goldstein). Dr Sloan is now with Duke University. Ms. Githens is now with Indiana University, Indianapolis.

Footnotes
Reprint requests to Division of General Pediatrics, Suite 3963, The Vanderbilt Clinic, Nashville, TN 37232-5577 (Dr Hickson).

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