INITIATION OF MEDICAL MALPRACTICE SUITS - A CONCEPTUALIZATION AND TEST

Despite the concern with medical malpractice suits and research about them, little is known about why some perceived injuries lead to claims of malpractice while other similar injuries do not. This paper presen t a conceptualization and hypotheses regarding the determinants of an injury or perceived injury leading to suit. The conceptualization and hypotheses are tested using information collected from 113 medical mal practice plaintiffs' attorneys in three states. A series of proposed c oncepts prove useful in explaining patient willingness to pursue a sui t as well as the plaintiff's success and award size. These are concept s of anger, reluctance to sue, patient and provider worthiness, affini ty, economic burden and potential for compensation. Specific attribute s of the injury, the patient, the provider, and the doctor-patient rel ationship relate to these concepts. Injury and doctor-patient relation ship attributes prove more important than patient or provider attribut es. However, the reported impact of the attributes of the patient and physician on plaintiff success and award is high and suggests that the impact of ''non-relevant'' variables in the medical malpractice proce ss. Doctor-patient relationship variables hypothesized to reflect affi nity are reported to be important in reducing patient willingness to p ursue a case; and, certain populations, such as minorities, elderly, f oreign-born, are perceived to have a reluctance to sue. The effect of specific characteristics of the patient, the doctor, the injury and th e patient-doctor relationship on patient reaction and on disposition i s reported, as well as evidence that relates to the validity of the ov erall conceptualization.