Medical malpractice occurs when the negligence of a health care provider causes harm to one of their patients. This can be done in a local hospital, doctor`s office, hospital care facility, or pharmacy. Our results showed a greater likelihood of complaining about lack of consent in cases where patients were newborns. This finding was linked to another finding from our study, which suggests that lack of communication was a more common cause of discomfort on the part of the patient`s family (if the patient died or if the patient was a newborn or incapacitated). Evidence from the literature indicates the need for a family-centred approach in the medical setting to newborn care that requires the appropriate parent approach [40,42,43]. In a family-centred approach, parents and physicians form a partnership in which parents have the opportunity to actively participate in their child`s care [42,43]. Sarin and Maria (2019) reported that parents often show distress, frustration and alienation when they are not involved in the care of their own child [42], creating the conditions for complaints when the case is not successful. It is a physician`s responsibility to give the patient all the information they need to make an informed decision about surgery before surgery. The physician should offer facts about the procedure, its potential risks and benefits, what the patient risks if they do not have the procedure, and possible alternatives.
If the patient has not received sufficient information, they may not have consented, even if they have signed the discharge forms. This could expose the health center to responsibility for surgical errors or subsequent complications. Many people find that the most convenient and affordable way to file a malpractice lawsuit is to hire a medical malpractice lawyer. While anyone can sue for malpractice, most people don`t have the fact that emergency rooms are significantly different from typical hospital environments. Emergency rooms can see hundreds of patients a day, all facing urgent or life-threatening medical emergencies. Emergency rooms can easily become disorganized, chaotic and dangerous. Negligent staff or physicians may rush treatment, misdiagnose patients, fail to treat injuries, prescribe the wrong medications, confuse patients, or make other mistakes that ultimately harm patients. The emergency room could be held responsible for both employee mistakes and unsafe environments. Defensive medicine involves asking for more medical tests, more medical advice, prescribing more medications, more referrals to specialized examinations, refusing to perform certain high-risk procedures, or even refusing to help patients with serious illnesses.
These practices are not always to the benefit of patients; On the contrary, they expose them to unnecessary and sometimes risky procedures, increase the cost of medical care, and reduce physician satisfaction [2]. The study analysed data collected during the 14 years of activity of the Monitoring and Professional Competence Commissions in cases of misconduct in the Moldova region of Romania. Our results showed several results that could be the starting point for formulating prevention methods to reduce the number of treatment errors. We tested the association between the above reasons and some of the study variables related to the applicant (residential area, sex, whether the patient had died, whether the applicant was the patient or a family member, whether the patient was hospitalised multiple times if the patient was a newborn) and found several statistically significant results. Six of the grounds for complaint (malpractice, reasons suggested by colleagues, inappropriate communication between team members, administrative reasons, legal reasons, and lack of competence or professionalism) were not related to any of the above variables. The remaining nine had associations with study variables in different ways, as shown below. Misdiagnosis was a cause of complaint identified in 19 cases (12.4%) involving a number of 28 (13.65%) physicians, the three most frequently affected specializations for this reason being paediatrics (4 complaints, 6 physicians), obstetrics and gynecology (2 complaints, 3 physicians) and orthopaedics and traumatology (2 complaints, 5 physicians). This was a more likely cause of discomfort in patients who had stayed in hospital several times. Lack of diagnosis was a cause for complaint in 8 cases (5.22%) involving 11 (5.36%) physicians, with general surgery (2 complaints, 4 physicians) being the most affected specialty. Although the data in the literature most often refer to misdiagnosis in general (lack of diagnosis, misdiagnosis and delay in diagnosis), the results of our study showed a lower percentage than those reported in other studies. For example, 32.1% of complaints related to the diagnosis of Gupta et al.
(2018) were reported, of which 38.8% were hospitalized patients [46]. Gupta et al. (2018) observed a decrease in this percentage over the 13 years of the study period (January 1, 1999 – December 31, 2011), which can be explained by the increasing accessibility of diagnostic techniques, particularly in the field of medical imaging [46]. Ambulatory diagnostic errors were estimated at 5.1% of cases [46]. Schaffer et al. (2017) found that diagnostic errors were the most frequently reported reason for paid claims in 31.8% of these cases [47]. Misdiagnosis was the most common cause of complaints in the study by Saber Tehrani et al. (2013), which showed that misdiagnosis was associated with the highest cost and degree of danger to patients [48]. Our research shows that people in rural areas are more likely to report inappropriate behaviour than people in urban areas.
In rural areas, the relationship between physicians and their patients is much closer [28,29]. This closer relationship may lead the patient to prefer to wait a long time (sometimes even a few hours) to be examined by their own doctor when they are very busy, or even to postpone a consultation if their doctor is not available, rather than contacting another doctor [28]. Interpersonal relationships tend to be closer in rural areas where communities are small, people communicate more with each other (for example, they usually greet everyone, even if they don`t know each other), they live in community. The rural environment is characterised by greater social integration compared to the urban environment, with friendly and neighbourhood support and community participation [30]. The rural patient, accustomed to close interpersonal relationships in his area of residence, both with the community and with the physician, is disturbed when urban physicians with less time for patients interact less with the patient, behave more distant and sometimes arrogant, as some patients in our study pointed out. These questions become more relevant if the outcome of the medical intervention does not meet the patient`s expectations. Medical malpractice complaints continue to follow an upward trend worldwide, and their consequences are manifold and affect both medical staff and patients and society at large. There is therefore an urgent need to find solutions to reduce the number of complaints, an objective that could be achieved by conducting studies to make recommendations in this regard. The increased risk of certain medical specialties for malpractice claims is mainly due to the specifics of the medical services provided and patients treated. Doctors in obstetrics and gynecology, for example, treat not just one patient, but often at least two (mother and child) or even three, if we take into account the concerns of the future father, while taking care of the reproductive system of the woman, it is also about potential future patients, the reproduction of the human species, It therefore becomes a specialty of the whole family [4]. Patients who use obstetrics and gynecology often expect more than a doctor can actually do and demand impeccable results from medical procedures, such as safe work when the child is to be born [18]. Becoming parents can be an overwhelming problem, and the perinatal period is characterized by many emotions related to the health status of the newborn.
Therefore, this emotional distress in parents can become a trigger for complaints against professionals in the field if the newborn is not in good health [19].