What patient attributes are associated with thoughts of suing a physician?

Arch Phys Med Rehabil. 2007 May;88(5):589-96. doi: 10.1016/j.apmr.2007.02.007.


Objective: To address a neglected research area: the attributes of rehabilitation patients associated with "thoughts of suing a physician" (S-MD).

Design: The S-MD statement "I am thinking about suing one of my doctors" was administered to 2264 people, along with the Battery for Health Improvement (BHI 2). Items predictive of S-MD were identified.

Setting: Acute physical therapy, work hardening programs, chronic pain programs, physician offices, and vocational rehabilitation programs.

Participants: Participants included 777 rehabilitation patients and 1487 nonpatient community-dwellers.

Interventions: Not applicable.

Main outcome measures: We used a multivariate analysis of variance to determine which of the 18 BHI 2 scales predicted the S-MD statement. Items from the scales found to be predictive, plus other variables, were then used in a chi-square analysis that compared people who wished to sue with those who did not. We then used a stepwise regression analysis with significant items from the prior analyses to build a model for predicting a potential S-MD patient.

Results: The highest percentage (11.5%) of patients affirming the S-MD statement were those involved in workers' compensation and personal injury litigation, compared with only 1.9% of community-living subjects. Stepwise regression of BHI 2 variables produced a 13-variable model explaining 38.04% of the variance. A logistic regression of demographic variables (eg, education, ethnicity, litigiousness) explained 20% of the variance.

Conclusions: Anger (P<.001), mistrust (P<.001), a focus on compensation (P<.001), addiction (P<.001), severe childhood punishments (P<.001), having attended college (P<.001), and other patient variables were associated with thoughts of suing a physician.

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health
  • Female
  • Fibromyalgia / psychology
  • Headache / psychology
  • Humans
  • Male
  • Malpractice / legislation & jurisprudence*
  • Middle Aged
  • Patient Satisfaction / legislation & jurisprudence
  • Patients / psychology*
  • Physician-Patient Relations
  • Physicians / legislation & jurisprudence*
  • Reflex Sympathetic Dystrophy / psychology
  • Regression Analysis
  • Socioeconomic Factors
  • Workers' Compensation
  • Wounds and Injuries / psychology