| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 101 === Background：Medical malpractice cases increased year by year. Physicians are under a lot of pressure and accountability when errors or disputes occur in medical services. Many studies have pointed out negative impacts on physicians experiencing medical malpractice events. Physicians need a long time to adapt and adjust the pressure that is difficult for outsiders to imagine. Therefore, in order to ensure that medical providers can continue to provide high-quality medical care, and how to provide appropriate support when disputes occur, it’s necessary to understand the influence on physicians experiencing medical malpractice events.
Objectives：To understand the experience of physicians experiencing medical malpractice and the influence on physicians. To explore the adaptation process of physicians encountering medical malpractice events, and to analyze physicians’ psychological adjustment and social adaptation.
Methods：This qualitative study adopted in-depth interview and Snowball Sampling. There were eighteen physicians who experienced medical malpractice participating in semistructured interview. Data were collected from November 2012 to March 2013. Data analysis summarized the views expressed by physicians, using Qualitative Comparative Analysis (QCA) method to present the interrelationship between several pieces of information.
Results：(1) Court room scenarios are stressful for physicians. Some physicians also think that the litigation process is too lengthy and time-consuming. If patients and their families have irrational responses to physicians, physicians will have more obvious stress, especially clinic physicians. (2) The impact of physicians experiencing medical malpractice events can be divided into negative psychological influence, medical behavior change and reduced enthusiasm. Negative emotions last for a long period of time. Physicians in medical practice are more likely to take on defensive medicine, and the most obvious influence to physicians is reduced enthusiasm, especially when those cases have no positive impact on physicians; for instance, those involving patients’ death, or causing unfair feeling to physicians. (3) Physicians often require a period of time to recover and adapt after experiencing medical disputes. Most physicians will seek help by talking their feelings to others. Some physicians have inner-adaptated ability, but most of them are in need of social support. (4) Physicians experiencing medical malpractice process have a predictable recovery trajectory. The process has five stages as follows: (1) confusing & thinking, (2) influence, (3) adaptation, (4) changing in attitude, and (5) moving on.
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