title: Impact of litigation on senior clinicians: implications for risk management.
abstract: OBJECTIVE
  To investigate the impact of litigation on consultants and senior registrars and to establish their views on methods of reducing adverse events and litigation.
  
  
  METHODS
  Postal survey.
  
  
  METHODS
  Acute hospitals in the North Thames (West) Regional Health Authority.
  
  
  METHODS
  1011 consultants and senior registrars in acute hospitals.
  
  
  METHODS
  Perceived causes and effects of adverse events; views on methods of reducing litigation and adverse events.
  
  
  RESULTS
  769 (76%) doctors responded. 288 (37%) had been involved in litigation at some point during their career; 213 surgeons (49%) and 75 (23%) doctors in the medical specialties. Anger, distress, and feeling personally attacked were common responses to litigation. Clinicians' views on reducing litigation emphasised the need for change at the clinical level. Supervision of junior staff, workload, and training in communication skills were to the fore.
  
  
  CONCLUSIONS
  The high frequency of doctors who have experienced litigation and the emotional responses described indicate that clinicians require support at several levels. At a personal level, support can be offered to clinicians going through the litigation process or after an adverse event. Also, managerial support is needed by offering financial and practical help in correcting the factors that have been consistently identified as producing high risk situations to minimise the possibility of a reoccurrence. Accidents in medicine are, by their very nature, costly in human and financial terms and the root causes must be tackled. Recommendations are made for clinicians and risk management teams.
authors.affiliation: Directorate of Public Health, North Thames Region, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Bark
authors.forename: C
authors.initials: C
authors.lastname: Vincent
authors.forename: L
authors.initials: L
authors.lastname: Olivieri
authors.forename: A
authors.initials: A
authors.lastname: Jones
mesh_terms: D001291:Attitude of Health Personnel; D004739:England; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000331:legislation & jurisprudence / Q000523:psychology* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D012308:Risk Management / Q000458:organization & administration*; D012944:Social Support; D013222:State Medicine; D013315:Stress, Psychological; D011795:Surveys and Questionnaires