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Social Problems

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Pamela Anne QuirozNilda Flores-González

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Changing Medical Practice and Medical Malpractice Claims

Stephen L. Fielding
DOI: http://dx.doi.org/10.2307/3097004 38-55 First published online: 1 February 1995

Abstract

I use statistical data to describe the populations of malpractice claims in New York and Massachusetts, and in-depth interviews with physicians and claimants to explore the human side of medical malpractice claims. I argue that medical malpractice claims are associated with tertiary medical care delivered within a business setting. Several major themes emerge from my analysis. There is a strong distinction between physicians' and claimants' definitions of medical outcomes. Physicians judge medical outcomes in terms of generally accepted medical practice. In contrast, patients judge medical outcomes in terms of how their lives have changed. Physicians voice their concerns about the uncertainty in the practice of medicine. Marginalization, which occurs when physicians push their patients' personal and social concerns related to their treatment to the periphery, is a major concern of claimants. The physicians' interviews also contain themes of anger, distrust of patients, and defensive medicine; patients' themes include anger, vindication, and deference towards their former physicians. Finally, some physicians and claimants view medicine more as a business rather than as a humanistic institution.