Australian doctors are relatively unfussed by medical negligence claims, which are not associated with any significant declines in mental or physical health, a study has found.
Based on figures from the MABEL (Medicines in Australia, Employment and Life) survey, the surprising finding is likely related to Australia’s strong medical indemnity industry and laws which disincentivise speculative litigation, say researchers from the University of Melbourne.
They say it contrasts with overseas research showing litigation was identified by doctors as their most stressful life experience: more so than divorce or the death of a spouse.
And a recent survey of nearly 8000 UK doctors found those recently involved in a lawsuit were twice as likely to report suicidal ideation or moderate-severe depression and anxiety than those who weren’t, they wrote in BMJ Open.
However, previous research had not been able to distinguish between causes and consequences of negligence claims, the authors said.
This was because most earlier studies on the topic were cross-sectional surveys, unlikely the longitudinal MABEL survey, answered by around 15,000 doctors annually until it concluded in 2018.
In the final seven years of the survey, some 885 (5.9%) doctors reported having been sued at least once in their careers, with GPs and male doctors being the most likely to have been through a lawsuit.
But their self-rated health generally did not decline in the year of the claim, nor in any subsequent year, the authors found.
The same was true with their self-rated sense of life satisfaction, which had no significant statistical link with being sued.
“While there are reports of doctors who have died by suicide in the context of medical regulatory investigations, our large longitudinal analysis of doctors in Australia found no association between medical negligence claims and poor doctors’ health,” they wrote.
“This may be because medical negligence claims have less impact on doctors compared with regulatory complaints or investigations.”
It was also likely the case that Australia’s legal system was friendlier to doctors than that of other countries such as the US, they said.
They pointed to legal reforms introduced 20 years ago to curtail medical negligence litigation which capped compensation payouts and mandated mediation, while medical indemnity insurance had been compulsory for some time.
“Of those medical negligence claims that are commenced, the overwhelming majority settle out of court on confidential terms,” the authors said.
“This may mean that Australian medical negligence claims are rarely subject to media scrutiny and are less likely to inflict financial or reputational damage on doctors.”
“Our results may also suggest that sued doctors in Australia are better supported professionally and personally, compared with overseas.”
Nevertheless, the authors stressed there was some reason for concern given self-rated health and life satisfaction did decline on average throughout the duration of the study.
“This reinforces the pressing need for ongoing efforts to support doctors’ health and well-being, particularly during the pandemic,” they said.
“As a group, unwell doctors are often silent and invisible with few available avenues of peer support. “
“This needs to change, as prior research shows that doctors enjoy better psychological well-being when supported by family, colleagues or employers.”