The Influence of Legal Proceedings on French General Practice: A Qualitative Study

Aurélia Nachbauer, Humbert de Fréminville

General Practitioner Department, University of Lyon 1, Lyon, France.

DOI: 10.4236/jss.2014.26045                

Abstract

Legal proceedings are becoming increasingly common in our society and especially in medicine. This raises the question as to whether General Practitioners (GPs) are concerned by this phenomenon. This study explores the impact of proceedings on the feelings and behaviors of different doctors. A qualitative semi-structured interview with 13 French GPs based on grounded theory was performed. A thematic analysis with major themes was then performed. This survey shows that lawsuits have little impact on the daily practice of GPs. Defensive medicine is practiced in certain specific situations: the treatment given, a patient known or perceived to be litigious. GPs attach importance to information and communicating to the patient. The primary concern of GPs remains their patients. They are not subject to daily anxiety over the risk of lawsuits.

Keywords

Consultation, Managed Care, Risk Assessment, Doctor-Patient Relationship, Primary Care, Medical Errors

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Studdert, D.M., Mello, M.M., Sage, W.M., Des Roches, C.M., Peugh, J., Zapert, K. and Brennan, T.A. (2005) Defensive Medicine among High-Risk Specialist Physicians in a Volatile Malpractice Environment. The Journal of the American Medical Association (JAMA), 293, 2609-2617. http://dx.doi.org/10.1001/jama.293.21.2609
[2]	Summerton, N. (2000) Trends in Negative Defensive Medicine within General Practice. British Journal of General Practice, 50, 565-566.
[3]	Kessler, D.P., Summerton, N. and Graham, J.R. (2006) Effects of the Medical Liability System in Australia, the UK, and the USA. Lancet, 368, 240-246. http://dx.doi.org/10.1016/S0140-6736(06)69045-4
[4]	Nash, L.M., Walton, M.M., Daly, M.G., Kelly, P.J., Walter, G, Van Ekert, E.H., Willcock, S.M. and Tennant, C.C. (2010) Perceived Practice Change in Australian Doctors as a Result of Medicolegal Concerns. Medical Journal, 193, 579-583.
[5]	Nash, L.M., Walton, M.M., Daly, M.G., Johnson, M., Walter, G., Van Ekert, E., Willcock, S. and Tennant, C. (2009) GP’s Concerns about Medicolegal Issues―How It Affects Their Practice. Australian Family Physician, 38, 66-70.
[6]	Cunningham, W. and Dovey, S. (2006) Defensive Changes in Medical Practice and the Complaints Process: A Qualitative Study of New Zealand Doctors. New Zealand Medical Journal, 119, U2283.
[7]	Fasquelle, N. and Faict, T. (2006) La judiciarisation de la médecine générale et la pratique médicale. Thèse d’exercice de Médecine, Faculté de Médecine de Clermont Ferrand I, Clermont Ferrand.
[8]	Bourcier, J. and Bismuth, S. (2006) La judiciarisation et l’exercice de la médecine générale en 2005: Réflexions à propos d’une enquête auprès de 136 médecins généralistes de la région Midi-Pyrénées. Thèse d’exercice de Médecine. Faculté des sciences médicales Rangueil, Toulouse.
[9]	Gubrium, J.F. and Holstein, J.A. (1997) The New Language of Qualitative Method. Oxford University Press, New York.
[10]	Briggs, C.L. (1986) Learning How to Ask: A Socio-Linguistic Appraisal of the Role of the Interview in Social Science Research. Cambridge University Press, Cambridge, London, New York. http://dx.doi.org/10.1017/CBO9781139165990
[11]	Spradley, J. (1979) The Ethnographic Interview. Holt Rinehart & Winston, New York.
[12]	Silverman, D. (2010) Doing Qualitative Research: A Practical Handbook. 3rd Edition, Sage Publications, London.