Psychological morbidity in Australian doctors who have and have not experienced a medico-legal matter: cross-sectional survey.
OBJECTIVE
To describe the differences in psychological morbidity between Australian general practitioners (GPs) who have experienced a medico-legal matter and those who have not.


METHODS
A total of 1,499 GPs were initially invited to participate in the study. Two hundred and sixty requested not to participate, with 1,239 subsequently being sent a survey. There were 566 respondents (45.7% response rate to survey). There were two sources of data. First, a cross-sectional survey sought demographic information, personality traits via the Eysenck Personality Questionnaire (EPQ), history of a medico-legal matter with any medical defence organization, and measures of psychological morbidity, including the General Health Questionnaire (GHQ), Sheehan Disability Scale (SDS), and Alcohol Use Disorders Identification Test. Second, information was extracted from the United Medical Protection database on medico-legal matters.


RESULTS
Fifty-nine per cent of respondents to the survey reported ever having a medico-legal matter, with 13% having a current medico-legal matter. Those with a current matter reported increased levels of disability (in work, social or family life) and higher prevalence of psychiatric morbidity (45% vs 27% GHQ 'case identification' rates), compared to those with no current matter. Those respondents with a history of past medico-legal matters reported increased levels of disability (SDS) and depression subscores (GHQ). Male respondents drank significantly more alcohol than female respondents, and male respondents with current or past medico-legal matters had significantly higher levels of alcohol use than male respondents with no experience of medico-legal matters.


CONCLUSIONS
Doctors who have current and past medico-legal matters have a higher level of psychological morbidity. The study design was unable to distinguish cause or effect. A longitudinal study is planned to investigate this. The findings have significant implications for medical training, doctor support systems and medical insurance groups.
Nash
Louise
L
Department of Psychological Medicine, Royal North Shore Hospital, St Leonards, Australia. lnash@med.usyd.edu.au
Daly
Michele
M
Johnson
Maree
M
Walter
Garry
G
Walton
Merrilyn
M
Willcock
Simon
S
Coulston
Carissa
C
van Ekert
Elizabeth
E
Tennant
Chris
C
D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D004185:Disability Evaluation; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005555:Forensic Psychiatry / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D007603:Jurisprudence; D008297:Male; D008318:Malpractice / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D010815:Physician Impairment / Q000706:statistics & numerical data*; D012737:Sex Factors; D011795:Surveys and Questionnaires