Causes of negligence by the patients

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Causes of negligence by the patients: They are:


  • Breakdown in physician-patient relationship; or utter disregard for the life and safety of the patient (poor and ineffective communication with the patient and his relatives).
  • Rude behaviour of the physician.
  • Less frequent house calls.
  • Complex invasive procedures for diagnosis and treatment with resulting death or disability.


  • Unrealistic expectations of cure.
  • Poor compliance with medical recommendations.
  • Frequent self-destructive behavior (heavy smoking, drinking, use of drugs, poor dietary management).
  • Increasing awareness of rights.
  • Comments on the treatment by another doctor.
  • Lack of consent.
  • Lack of documentation, such as provisional diagnosis, relevant findings, etc.
  • Not taking second opinion whenever there is a problem and not informing relatives if patient is serious.
  • Mis-perception of physician’s role in the society, or his affluence.

(III) MEDIA RELATED: Biased publicity of negligent suits and the size of awards.


  • Lack of experience.
  • Monetary considerations.


  • Increased cost of medical care.
  • Payment by insurance companies.


  • Mobile population.
  • Consumers rights.
  • General increase in litigation.

Defensive medicine: Defensive medicine is ordering every test or X-ray on a patient to have a good background of hard data, and avoiding using a potentially risky treatment which may offer much benefit to the patient. This may lead to withholding of beneficial treatment to the majority of patients because of a statistical risk to the minority. The physician must not practice ‘defense by denial”, and claim that the patient is not his, which becomes abandonment.


(1) Establish good rapport with the patient, also with patient’s families, with fellow physicians and with nursing and paramedical personnel, who may commit errors. The patient should be told of everything. Complications should be spotted out and treated.

(2) Rationale: The doctor should use all available and relevant information to make diagnosis and formulate the treatment (history, physical examination, laboratory tests, X-rays, etc.). An error in judgement is not negligence. Seek consultation where appropriate.

(3) Maintain complete accurate, legible medical records. Records are the most important evidence (diagnostic and therapeutic).

(4) Obtain informed consent of the patient. Do not criticise any member of the treatment team in front of the patient. Do not criticise another physician.

(5) Establish hospital injury prevention programme. If an untoward result occurs, explain to the patient and treat it. Transfer the patient if the facility is incapable or inadequate to handle his problem. If a patient suffers damage due to negligence, it is better to compensate the patient.

(6) Respect: An attitude of care and concern, a relationship that suggests thoughtful professionalism and a humanistic approach many times solves problems. Treat the patient as the physician would wish himself or a member of his family to be treated.

(7) Risks: Inform the patient of all side-effects and anticipated risks. Risks must be identified carefully, controlled and managed to prevent injury to patients, i.e. good, desirable and achievable “patient care”. The patient and his family should be told of the possible outcome of the treatment, available alternatives, and the result to be anticipated if nothing is done.

(8) Maintain good records on accidents, suicides, medication errors, or problems.

(9) Continuing education of physicians.

(10) Participation in medico-legal seminars.



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