Study: Rude Doctors Sued More

CHICAGO - Primary-care doctors who rush their patients through are more likely to be accused of malpractice than those who take more time, encourage people to talk and inject a little humor, a study suggests.

The study, which used audiotapes to record how doctors acted, is important in light of pressure on managed-care organizations to curb costs by shortening patient visits.

"When faced with a bad outcome, patients and families are more likely to sue a physician if they feel the physician is not caring and compassionate," said Dr. Wendy Levinson, a University of Chicago medical professor and co-author of the study appearing today in the Journal of the American Medical Association.

A medical-consumer advocate, Dr. Sidney Wolfe of the Public Citizen Health Research Group, said the findings should be a warning to health-maintenance organizations.

"The focus in the HMO industry has been profit," Wolfe said, "and HMOs should pay attention to this study because they are heading for trouble."

In the federally financed study, researchers audiotaped 10 patient visits each with 59 primary-care physicians and 65 general and orthopedic surgeons.

In analyzing the tapes, the researchers focused on four factors: the length of the visits, doctors' explanations to patients, whether they encouraged patients to talk about their problems and whether they injected humor and warmth. The study looked only at those factors and made no effort to judge the quality of care.

Doctors who had been contacted two or more times by patients or their lawyers wanting malpractice compensation - even if no suit was eventually filed - averaged 15 minutes for office visits. Those who had been contacted fewer than twice averaged 18.3 minutes.

Levinson said that by listening to the tapes and scoring doctors on how they interacted, researchers were able to pinpoint with 75 percent accuracy those who were more likely to face malpractice claims, and with 84 percent accuracy those who weren't.

The researchers also found that the office manners of surgeons did not appear to make a difference when it came to malpractice claims. Levinson theorized that patients may see surgeons more as technical specialists and thus expect a more businesslike approach.