Should I Be Concerned About Risk If I'm Not Personable?

​​​​​​​Question: I run a respected chiropractic practice in my community. I take pride in the fact that I keep up to date on the latest techniques, as well as clinical research and trends. But recently a patient commented that I'm not really a “warm, fuzzy type of doctor.” Should I be concerned?

Posted in Risk Management on Friday, June 9, 2017

Answer: Of course excellent clinical care is a primary goal of any healthcare practitioner. However, it is smart not to overlook the importance of a positive bedside manner. Research has shown that doctors who are considered “warm” and “personable” are less likely than their standoffish counterparts to be sued.

In his bestselling book, Blink: The Power of Thinking Without Thinking,* Malcolm Gladwell said that the risk of being sued for malpractice has very little to do with how many mistakes doctors make. His analysis of medical malpractice lawsuits showed some highly skilled doctors were sued often, while other doctors who make lots of mistakes were never sued.

“Patients file lawsuits because they’ve been harmed ... [and] how they were treated, on a personal level, by their doctor,” said Gladwell. He pointed to findings by medical researcher Wendy Levinson who recorded hundreds of conversations between a group of physicians and their patients.

Levinson found the surgeons who had never been sued spent more than three minutes longer with each patient than those who had been sued did (18.3 minutes versus 15 minutes).

The doctors who were not sued also helped patients understand what would happen during the exam and provide reassurance with comments like, “First, I’ll examine you, and then we will talk the problem over.” Levinson also found the doctors who were not sued were more likely to engage in active listening and laughter.

The analysis was taken a step further by psychologist Nalini Ambady who had the tapes evaluated for intonation, pitch and rhythm to discern qualities of warmth, hostility, dominance and anxiousness. She found with those ratings alone, she could predict which surgeons got sued and which ones didn’t.

Surgeons with voices that were judged to be dominant tended to be in the sued group. Those who sounded less dominant and more concerned tended to be in the non-sued group.

On its surface, an allegation of malpractice seems like it would be driven by many intricate factors, and many cases do become complex by the time they go to court. But there is a very simple thing you can do to reduce your chance of a malpractice allegation: Focus on the time you spend with your patients, making sure your demeanor and tone of voice reflect the caring and concern you feel for your patients

^{* Gladwell, M. (2005). Blink: the Power of Thinking without Thinking. New York: Bayback Books/Little Brown and Company}