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Biomedical subjects

S C Charles

Publications and source records attributed to S C Charles.

At least 19 recordsLinked to original sources
PubMed1999

How to handle the stress of litigation.

The article describes the psychological repercussions of being sued for malpractice. Although most physicians experience at least some emotional disruption during the process, they usually cope effectively. Factors that contribute to stress vulnerability as well as preventive measures are described. The influence of commonly shared personality features and the fact that tort law is fault based are explored in order to provide a psychological understanding of the litigation experience. General and specific approaches toward coping, including the importance of social support during the process, are offered.

Adaptation, Psychological↗
PubMed1995

Role of previous claims and specialty on the effectiveness of risk-management education for office-based physicians.

We analyzed the medical malpractice claims data of 1,903 physicians between 1981 and 1990 to assess the efficacy--a reduced incidence of future claims and decreased payout in the event of a claim--of risk-management education for office-based physicians. Physicians were participants in the Oregon Medical Association's medical liability program and represented all recognized specialties and all geographic areas of the state. Each physician's claim and payout history before and after 4 sequential risk-management education programs was entered into a random-effects probit model that allowed for a longitudinal rather than a cross-sectional analysis. For most physicians, there was increased claim vulnerability following 1 or 2 risk-management education courses but decreased vulnerability after additional courses. Among all physicians, having a previous claim substantially increased the risk for a future claim. Risk for an additional claim doubled (from 7% to 14%) for physicians who had a claim in the previous year. Of all specialists who have had claims, anesthesiologists (reduction in claims incidence from 18.8% to 9.1% and in payout from 14.6% to 5%) and obstetrician-gynecologists (reduction in claims incidence from 23.3% to 15.2% and in payout from 11.6% to 4.2%) benefit most from cumulative risk-management education.

Humans↗
PubMed1993

The doctor-patient relationship and medical malpractice litigation.

Little empirical data support the allegation that a good doctor-patient relationship prevents litigation. However, physicians--including psychiatrists--should be alert to critical events that generate anxiety in both doctor and patient and thus disrupt the equilibrium of their relationship. The author discusses reactions in doctor and patient that may lead to further disequilibrium, the outcome of which may be litigation.

Attitude of Health Personnel↗
PubMed1992

Predicting risk for medical malpractice claims using quality-of-care characteristics.

The current fault-based tort system assumes that claims made against physicians are inversely related to the quality of care they provide. In this study we identified physician characteristics associated with elements of medical care that make physicians vulnerable to malpractice claims. A sample of physicians (n = 248) thought to be at high or low risk for claims was surveyed on various personal and professional characteristics. Statistical analysis showed that 9 characteristics predicted risk group. High risk was associated with increased age, surgical specialty, emergency department coverage, increased days away from practice, and the feeling that the litigation climate was "unfair." Low risk was associated with scheduling enough time to talk with patients, answering patients' telephone calls directly, feeling "satisfied" with practice arrangements, and acknowledging greater emotional distress. Prediction was more accurate for physicians in practice 15 years or less. We conclude that a relationship exists between a history of malpractice claims and selected physician characteristics.

Clinical Medicine↗
PubMed1990

Malpractice litigation as a factor in choosing a medical specialty.

Although many factors have been identified as influencing specialty choice, there has been no research focusing on the effects of the current climate of medical practice, including litigation. Our study examines medical students' and residents' awareness of the malpractice litigation environment and their reasons for choosing a specialty that is at either high or low risk for malpractice suits. Longitudinal data showed that students continued to choose high-risk specialties (40%) even though they perceived problems in the current climate of litigation. Among the reasons for their choices were enjoyment and being able to practice in a procedure-oriented specialty that is effective in its mode of treatment. Those who chose low-risk specialties (60%) rated as important the variety of diseases seen and the opportunity to know patients well. Issues related to the malpractice climate were important only to those who switched from a high- to a low-risk specialty. These findings have implications for professional staffing needs.

Career Choice↗
PubMed1988

Appraisal of the event as a factor in coping with malpractice litigation.

The authors designed a study to explore medical malpractice litigation as a stressor, factors that contribute to doctors' appraisal of it, how they actually cope with it, and the potential effects on them and on their mode of practice. We interviewed 51 physicians who had been sued for medical malpractice. Those who identified litigation as their most stressful life event (Group 1, N = 11) experienced significantly more physical and emotional symptoms, especially those suggestive of a major depressive disorder, and used more emotion-focused coping mechanisms than those who identified some other event in life as being most stressful (Group 2, N = 39). The appraisal of litigation as one's most stressful life experience may be a useful predictor of coping response, with previous life experiences as a major contributing factor to this appraisal.

Adaptation, Psychological↗
PubMed1988

Psychological reactions to medical malpractice suits and the development of support groups as a response.

For doctors to cope with litigation effectively, it is critical that they obtain accurate information about the current climate of litigation. Despite the considerable evidence that the core issue is not one of gross physician negligence, there is still no substitute for the feelings of competence and self-confidence that derive from adherence to the highest standards of medical knowledge and care. When a suit occurs, these feelings are often the best antidote for the hurt and depressed feelings that almost always arise. It behooves the doctor to try to deal as effectively as possible with the symptoms and behavioral responses to litigation because of the subtle impact such changes have on doctor-patient relationships and patient care.

Adaptation, Psychological↗
PubMed1987

Psychiatric evaluation of morbidly obese patients.

Psychiatric consultation should be integral to the overall evaluation of morbidly obese patients prior to any treatment but particularly before surgery. In addition to clarifying the presence or absence of diagnosable psychiatric illness, which then may affect the decision to proceed to surgery, psychiatric consultation can elicit data on psychological disturbances that are neurotic or indicative of a personality disorder or trait that may affect treatment. Important developmental and life history data contribute to an understanding of the patient and the role of eating behavior in the patient's life, which in turn aids the entire treatment team in establishing a more effective and mutually cooperative approach to treatment.

Body Image↗
PubMed1985

Sued and nonsued physicians' self-reported reactions to malpractice litigation.

To assess the impact of malpractice litigation on physicians' personal and professional lives, the authors surveyed a random sample of the Chicago Medical Society membership. Although both sued and nonsued physicians reported changes in professional behavior and emotional reactions to both the threat and actuality of litigation, sued physicians reported significantly more symptoms than nonsued physicians. Significantly more of them reported that they were likely to stop seeing certain types of patients, think of retiring early, and discourage their children from entering medicine. Malpractice litigation may affect not only physicians' personal and professional lives but also the delivery of health care.

Attitude of Health Personnel↗