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August 22, 1977

MalpracticeThe Problem in Perspective

JAMA. 1977;238(8):861-863. doi:10.1001/jama.1977.03280090025014

Malpractice, for all intents and purposes, is ordinary negligence or carelessness. By legal definition, it is an unintentional act; that is, you cannot form the intent to commit an act of ordinary negligence. You may be intentionally careless, but such act would not come within the definition of ordinary negligence or malpractice. Rather, it would be categorized as willful and reckless misconduct, and I can assure you that this distinction is more than a paper one if for no other reason than the substantially greater amount of monetary damages awarded in the latter case.

If you cannot form the intent to commit an act of ordinary negligence then, conversely, it is logical and correct to postulate that you cannot, by an act of the will, prevent ordinary negligent conduct. The act of ordinary negligence which will occur with statistical surety in a random fashion in all our daily lives can only be prevented by diligent conduct—by the practice of good medicine. You assure yourself that good medicine is practiced by participating in ongoing medical education programs and continuous association with those persons and practices which will maintain your intellectual capacity. Worrying about the occurrence of acts of negligence is of no value and is often harmful.