A Study of Impact from Physicians'' Experience, Knowledge and Attitude of Malpractice on Practice Behavior in Taipei Metropolitan Area

• Main Authors: Chao-Wen Lu, 盧昭文
• Other Authors: Kuo-Piao Chung
• Format: Others
• Language: zh-TW
• Published: 1999
• Online Access: http://ndltd.ncl.edu.tw/handle/54913445841565635006

碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 88 === The purposes of this study include: first, to understand physicians’ attitude of malpractice and viewpoint of processing malpractice litigation in Taipei Metropolitan Area; second, to understand physicians’ experience on malpractice in Taipei Metropolitan Area; third, to explore the factors which influence physicians’ practice behavior and coping behavior due to malpractice. This is a cross-sectional study consisting of both quantitative and qualitative parts. In quantitative part, a structural questionnaire is developed and mailed to the internal medicine physician, surgeons, gynecologists and obstetricians, and pediatricians. It concluded the physicians'' experience, knowledge, and attitude on malpractice and its impacts on practice behavior. The response rate is 10.73 percent. The major analytic methods cover from descriptive analysis, bivariate analysis, factor analysis and multi-variate analysis of linear regression. In qualitative part, nine physicians were selected for in-depth interview about malpractice related topics. In quantitative research, three important findings included the following: 1.There are 8.37 percent physician in our research had the experience on malpractice during 1998. One major reason of malpractice is patients’ death. Surgeons have the highest possibility to encounter malpractice. 2.According to hypotheses testing, those factors related to the impact on physicians'' behavior included: "physician-patient relationship factor", "litigation processing factor", "procedure distrust factor", "law applicability and litigious reason factor". 3. According to hypotheses testing, those factors related to coping behavior cause by malpractice included: "diagnostic prevention factor", "policy facilitating factor", "negative influencing factor", and"physician-patient relationship factor". From qualitative research, major findings included the following: 1.The factors that impact the physician-patient relationship included: physicians'' skill on explanation and communication, physicians’ technical competence and quality of care, and physicians'' personal characteristics 2.Those factors influence the occurrence in malpractice included: the patients'' dissatisfaction due to physicians'' bad attitude or poor communication; the bad medical outcome; and the uncertainty of in providing care. 3.The impact on malpractice included: distrust between physicians and patients, the loss of money, time and mentality, avoid choosing medical specialty of high risk, provide more explanation to patients, and increase the completeness of medical record. Three suggestions were made according to the research findings. First, the health authorities should communicate more about the procedures in processing malpractice and emphasize the importance of physicians'' continuous education and certification to reduce technical incompetence and negligence. Second, physicians should make use of physician-patient relationship to offer further explanation about treatment and consider patient''s ability to understand. Finally, the study also suggests that future study to extend the broader content of knowledge on malpractice by conducting qualitative research first. to obtain detail opinions from physicians.