Frank McClellan

Do Poor People Sue Doctors More Frequently? Confronting Unconscious Bias and the Role of Cultural Competency

BackgroundThere is a perception that socioeconomically disadvantaged patients tend to sue their doctors more frequently. As a result, some physicians may be reluctant to treat poor patients or treat such patients differently from other patient groups in terms of medical care provided.Questions/purposesWe (1) examined existing literature to refute the notion that poor patients are inclined to sue doctors more than other patients, (2) explored unconscious bias as an explanation as to why the perception of the poor being more litigious may exist despite evidence to the contrary, and (3) assessed the role of culturally competent awareness and knowledge in confronting physician bias.MethodsWe reviewed medical and social literature to identify studies that have examined differences in litigation rates and related medical malpractice claims among socioeconomically disadvantaged patients versus other groups of patients.ResultsContrary to popular perception, existing studies show poor patients, in fact, tend to sue physicians less often. This may be related to a relative lack of access to legal resources and the nature of the contingency fee system in medical malpractice claims.ConclusionsMisperceptions such as the one examined in this article that assume a relationship between patient poverty and medical malpractice litigation may arise from unconscious physician bias and other social variables. Cultural competency can be helpful in mitigating such bias, improving medical care, and addressing the risk of medical malpractice claims.

Medical Malpractice Law, Morality and the Culture Wars: A Critical Assessment of the Tort Reform Movement

Tort reform emerged as a major issue in the culture wars during the 2004 presidential election and continues to be a heavily debated issue today. While a community’s sense of social justice should dictate the values used to assess and shape tort law, different communities have widely varying perspectives of social justice. This article reflects on the potential impact of the culture wars on medical malpractice law and litigation and emphasizes the most critical criteria for assessing medical malpractice reform is how well the legal system protects, affirms, and restores the human dignity of both patients and health care providers. The article reasons there is not a one-size fits all medical malpractice tort system, and in order to prioritize human dignity, it is essential to take into account the cultural, social, and religious diversity within America and shift the focus from economic to dignitary priorities. Finally, the article discusses the profound health care consequences of illiteracy and low health literacy.