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Volume 88, Issue 5, Pages 589-596 (May 2007)


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What Patient Attributes Are Associated With Thoughts of Suing a Physician?

David A. Fishbain, MDabc, Daniel Bruns, PsyDdCorresponding Author Informationemail address, J. Mark Disorbio, EdDe, John E. Lewis, PhDb

Abstract 

Fishbain DA, Bruns D, Disorbio JM, Lewis JE. What patient attributes are associated with thoughts of suing a physician?

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.

a Rosomoff Comprehensive Pain & Rehabilitation Center, University of Miami School of Medicine, Miami, FL

b Department of Psychiatry, University of Miami School of Medicine, Miami, FL

c Department of Psychiatry, Veterans Administration Hospital, Miami, FL

d Health Psychology Associates, Greeley, CO

e Integrated Therapies, Lakewood, CO.

Corresponding Author InformationReprint requests to Daniel Bruns, PsyD, 1275 58th Ave, Ste C, Greeley, CO 80634

 This study was conducted without external funding. The study, however, reanalyzed data from a previous study that was funded and supported by Pearson Assessments.

 A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit upon 1 or more of the authors. Bruns and Disorbio receive Battery for Health Improvement 2 royalties.

PII: S0003-9993(07)00104-9

doi:10.1016/j.apmr.2007.02.007


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