Physician-Patient Communication

Donald Caminiti

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In medical malpractice litigations in recent years in Japan, it is notable that the growing number of medical negligence cases resulting in serious personal injury or wrongful death includes the issue of a doctor's explanation of the procedure to the patient as a pivotal point. The objective of this study was to identify factors of physicians' communication skills with patients, as related to their legal liability, and differences in doctors' communication skills with patients by the type of medical facility.

Methods: Decisions in medical malpractice cases between 1988 and 2005 in Japan, focusing on the issue of a physician's explanation, were analyzed in the study.

The content of each decision was summarized using the study variables (information about the patient, doctor, manner of the doctor's explanation, and subsequent litigation), and a database comprising the content of each decision (N = 100) was constructed. In order to evaluate an association between doctors' communication skills with patients and the outcome of the litigation, the analysis was performed based on the outcome of litigation or the type of medical facility.

Results: The ratio of acknowledged physician liability by court decision was lower in cases in which the doctor's explanation occurred before treatment or surgery (p = 0.013).

The ratio of acknowledged physician liability by court decision was higher in cases of elective or non-urgent treatment (p = 0.046). The ratio of acknowledged physician liability by court decision was higher in clinics than in hospital groups (p = 0.036).

The moral of this story seems to be that especially in elective treatment and treatment rendered in a clinic, it behooves physicians to take the time to adequately communicate and explain to patients the nature of recommended procedures and the attendant risks.