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Does Litigation Influence Medical Practice? The Influence of Community Radiologists' Medical Malpractice Perceptions and Experience on Screening Mammography¹

¹ From the Dept of Internal Medicine, Univ of Washington School of Medicine, Harborview Medical Ctr, 325 Ninth Ave, Box 359780, Seattle, WA 98104-2499 (J.G.E., J.S.F.); Ctr for Health Studies, Group Health Cooperative, Seattle, Wash (J.G.E., S.H.T., W.E.B., L.A.A.); Applied Research Program, National Cancer Institute, Bethesda, Md (S.H.T.); Cancer Research and Biostatistics, Seattle, Wash (W.E.B.); Dept of Biostatistics, Univ of Alabama at Birmingham, Birmingham, Ala (G.R.C.); Dept of Radiology, Emory University, Atlanta, Ga (C.J.D.); Lynn Sage Comprehensive Breast Ctr, Dept of Radiology, Northwestern Univ Feinberg School of Medicine, Chicago, Ill (R.E.H.); and Office of Medical Education, Dartmouth Univ, Hanover, NH (P.A.C.). Supported by Public Health Service grant HS-10591 (J.G.E.) from the Agency for Healthcare Research and Quality and the National Cancer Institute and surveillance grants U01 CA63731 (S.H.T.), 1 U01 CA86082-01 (P.A.C.), 5 U01 CA63736-09 (G.R.C.), and 5 U01 CA86076 (W.E.B.) from NIH and the Department of Health and Human Services and the National Cancer Institute. Received Mar 17, 2004; revision requested May 27; revision received Jul 30; accepted Sep 2. Address correspondence to J.G.E. (e-mail: jelmore{at}u.washington.edu).

View larger version (28K): [in a new window]   Figure 1. Bar graph shows that radiologists believed that their peers' recommendations were more influenced by malpractice concern than were their own recommendations.

View larger version (23K): [in a new window]   Figure 2. Graph shows no statistically significant associations between radiologist patient-recall rates and reports of prior medical malpractice claims. Each data point represents one radiologist, and error bars represent 95% confidence intervals.

View larger version (21K): [in a new window]   Figure 3. Bar graph shows that the majority (61%) of radiologists who consider leaving mammography on a monthly, weekly, or daily basis thought that their probability of being sued in the next 5 years was 50% or higher. Numbers below x-axis, which indicates how often a radiologist considered leaving mammography practice, are numbers of radiologists.

View larger version (24K): [in a new window]   Figure 4. Bar graph shows that, of radiologists who believed that their concerns about malpractice greatly increased the number of their recommendations for diagnostic mammography and/or US, the majority (56%) thought that their probability of being sued in the next 5 years was 50% or greater. Numbers below x-axis, which indicates how radiologists characterized the influence of malpractice on the number of their recommendations for diagnostic mammography and/or US, are numbers of radiologists.