Does the medical accident prevention and dispute resolution act respond to physicians’ fear? Examining the nature of fear of medical malpractice disputes among hospital-employed physicians in Taiwan

Abstract

Abstract Background: Although medical malpractice and the problems associated with it remain an important concern in the medical community, only a few studies have investigated the nature of the fear of medical malpractice disputes of physicians. Objectives: The aim of this study is to investigate the nature of hospital-employed physicians’ fear of medical malpractice disputes in Taiwan. Methods: In-depth interviews were conducted to analyze the physicians’ personal experiences and observations of medical malpractice disputes. Thirty hospital-employed physicians varying in age, subspecialties, gender, institution, length of time in practice, and affiliation participated in this study. Results: The physicians’ fear of medical malpractice disputes could be classified into two major categories, namely, perceived negative consequences and perceived risk factors. The perceived negative consequences are (1) litigation, (2) adversarial confrontation, (3) reputation damage, and (4) psychological stress. Contrarily, the perceived risk factors are (1) medical uncertainty, (2) work overload, (3) influence of the National Health Insurance (NHI), and (4) weakened physician–patient relationship. Conclusion: Physicians’ fear of medical malpractice disputes is about not just litigation but also other aspects. As tort reforms are not sufficient, other strategies, such as adequate protection and psychological support of physicians, are needed if a medical malpractice dispute has taken place to reduce the physicians’ fear. Moreover, physicians’ workloads and quality of medical care delivered should be ensured under the Budget Planning of NHI, as well as restoring a collaborative physician–patient relationship.