The effectiveness of physician risk management: Potential problems for patient safety

Background. Physician risk management (RM) has been mandated around the world in an effort to reduce pecuniary and nonpecuniary loss associated with avoidable patient injury. However, there has been little empirical RM assessment to determine whether physicians obtain an increased understanding of the law, clinical obligations defined by law, and reduced numbers of injury suits. This study attempts to begin this assessment. Methods. In this study, 210 U.S. primary care physicians were sent a survey requesting demographic information on RM activities, the definition of negligence, and evaluation of 10 patient injury jury verdict case scenarios using a Likert scale. Physicians were first asked to assess the care given by the scenario physician clinically; they were then asked to predict the actual jury verdict. Results. 138 (65.7%) responded. Although physicians participated in a broad array of RM activities, none were postitively associated with overall clinical assessment concordance with the actual jury verdicts. Indeed, over all cases, substantive self-study and RM seminar attendance Conclusion. Standard physician RM efforts may not be effective in promoting patient safety, may increase the risk of patient injury, and may not reduce pecuniary and nonpecuniary costs associated with patient injury.