Medical dispute cases involving traditional Korean medical doctors: A survey

Medical Dispute Cases Caused by Errors in Clinical Reasoning: An Investigation and Analysis

Studies that examine medical dispute cases (MDC) due to clinical reasoning (CR) are scarce in Taiwan. A retrospective analysis was undertaken to review MDC filed at four hospitals in Taiwan between 2011 and 2015. Cases were examined for the healthcare professionals involved, their relevance to CR errors, clinical specialties, and seniority. Seventy-eight MDC were identified and 57.7% of which were determined to be related to CR errors (n = 45). Among the 45 cases associated with CR errors, 82.2% (37) and 22.2% (10) were knowledge- and skill-related errors, respectively. The healthcare professionals with the most MDC were obstetrician-gynecologists (10/90, 11.1%), surgeons (8/90, 8.9%), and emergency physicians (7/90, 7.8%). The seniority of less than 5 years or lower had the highest number of attending physicians to be associated with MDC. In contrast, the highest seniority (>25 years) in the physician group and year 6 in the resident group are both shown with zero MDC. In our study, the larger hospitals had a significantly higher incidence of MDC compared to the smaller hospitals (Pearson Correlation Coefficient = 0.984, p = 0.016). An examination of MDC reveals the frequency and nature of medical errors in Taiwanese hospitals. Having identified that CR errors contributed a substantial fraction to the overall MDC, strategies to promote reasoning skills and hence reduce medico-legal issues help safeguard both patients and healthcare professionals.

Antecedents, Consequences, and the Role of Third Parties in the Trust Repair Process: Evidence Taken from Orthodontics

Orthodontic treatment has popularized in Taiwan. Healthcare institutions can be responsive in their coping strategies and determine whether third-party intervention should take place involving medical disputes related to orthodontics in order to repair patient trust. This study draws on orthodontic treatment to explore the effect of various trust repair strategies employed by healthcare institutions and third-party involvement positively affecting outcomes related to trust repair. Patients were recruited among those who have undergone orthodontic treatments, and 353 valid scenario-based questionnaires were collected through an online survey. Results revealed that: (1) the affective and informational repair strategies positively impacted trust repair while the functional repair strategy did not; (2) trust repair positively impacted patient satisfaction/word-of-mouth and mediated between repair strategies and satisfaction/word-of-mouth; and (3) third-party involvement moderated the relationship between trust repair and word-of-mouth. The findings suggest that rather than receiving monetary compensation, patients usually prefer that healthcare institutions acknowledge their fault, offer apologies, and engage in active communications to clarify the causes of medical dispute. Further, an objective third party should be involved to mediate the medical disputes to afford satisfaction all around.

Analysis of current situation and influencing factor of medical disputes among different levels of medical institutions based on the game theory in Xiamen of China: A cross-sectional survey

With continuous development of the Chinese health care system, the doctor-patient relationship is increasingly tense in recent years. China has witnessed a surge in medical disputes, including many widely reported violent riots, attacks, and protests in hospitals. This study aimed to help to theorize the doctor-patient relationship based on the game theory, and analyze the current situation and influencing factors for medical disputes among different hospitalsA total of 17 hospitals were randomly selected in Xiamen city, including 8 tertiary hospitals and 9 secondary hospitals. All medical dispute cases, between 2012 and 2014, were collected through questionnaires. Multiple logistic regression analyses were used to identify risk factors associated with medical disputes.In total, 896 medical dispute cases happened in 2012 to 2014, 733 (81.8%) of which occurred in tertiary hospitals. Medical disputes mainly were reported in the departments of obstetrics and gynecology (24.9%). The main causation of medical disputes was improper communication (24.0%) in tertiary hospitals and lower therapeutic skills (43.7%) in secondary hospitals, respectively. The negotiated rate (91.4%) in secondary hospitals was significantly higher than the tertiary hospitals (54.8%). The patients' age, occupation and the doctor's medical location, professional title were the main risk factors for the occurrence of medical violence.Relationships between doctors and patients have become worse increasingly, whereas doctor-patient disputes or conflicts and their compensation have aggrandized year by year. The game relationship of doctor-patient is noncooperation, dynamic, and incomplete information game, and the advantages of cooperation are far greater than the competition between doctors and patients. Therefore, we need to take targeted measures to prevent and control the medical disputes by establishing a harmonious doctor-patient relationship in different levels of medical institutions.

Potential media influence on the high incidence of medical disputes from the perspective of plastic surgeons

BACKGROUND/PURPOSE

The main purpose of this study is to investigate the prevalence of medical disputes among plastic surgeons in Taiwan and to elucidate their perspectives regarding the influence of medical litigation media coverage on the physician-patient relationship.

METHODS

A self-administered questionnaire was distributed among plastic surgeons attending a series of continuing education training lectures organized by the Taiwan Society of Plastic Surgery in 2015.

RESULTS

Of the 109 respondents, over a third (36.4%) had previously experienced a medical dispute. The vast majority of both physicians who had medical disputes (77.1%) and those who did not (72.1%) felt that the media tends to be supportive of patients in their reporting, and 37.1% of all plastic surgeons felt that the media always portrays the patient as a victim. Respondents who experienced medical disputes in this study felt that the top five leading causes of the high incidence of medical disputes were patient disappointment with procedure results (81.1%), insufficient patient psychological preparation or emotional instability (61.7%), inadequate risk communication on the part of the physician (64.9%), patient uneasiness with the procedure or perception of carelessness (60.6%), and insufficient physician training or incorrect medical evaluation (57.4%).

CONCLUSION

Over a third of the respondents had previously experienced a medical dispute. This study highlights the perception among plastic surgeons that the media reporting of medical disputes and medical litigation is biased in favor of the patients, with 37.1% of the plastic surgeons surveyed opining that patients are always cast as victims.