To the Editor.
—As a primary care physician in a public hospital, I have found most patients to be appreciative of the free care they receive. It has always been my impression that poor and uninsured patients are less likely to sue for malpractice. This leads me to hypothesize that practice setting and payment arrangements may influence the likelihood of a lawsuit, with fewer suits in a public hospital setting where payment for services is often not a part of the physician-patient relationship.In the study by Burstin et al,1 was there any evidence that the ownership of the hospital (ie, public or private) was a modifier of the association between patient income or payer and malpractice claims? Perhaps the poor are more likely to sue when cared for in a private hospital setting and less likely to do so in a public hospital setting.
Saitz R. Do the Poor Sue More?. JAMA. 1994;271(7):503. doi:10.1001/jama.1994.03510310033027