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January 30, 2019

Association of Emotional Intelligence With Malpractice Claims: A Review

Author Affiliations
  • 1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
  • 2Department of Surgery, University of Washington, Seattle
  • 3Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, California
JAMA Surg. 2019;154(3):250-256. doi:10.1001/jamasurg.2018.5065

Importance  Approximately 8% of physicians experience a malpractice claim annually. Most malpractice claims are a result of adverse events, which may or may not be a result of medical errors. However, not all medicolegal cases are the result of medical errors or negligence, but rather, may be associated with the individual nature of the patient-physician relationship. The strength of this relationship may be partially determined by a physician’s emotional intelligence (EI), or his or her ability to monitor and regulate his or her emotions as well as the emotions of others. This review evaluates the role of EI in developing the patient-physician relationship and how EI may influence patient decisions to pursue medicolegal action.

Observations  Several physician characteristics are associated with increased medicolegal risk. Some of these traits, such as sex, age, level of experience, and specialty, are inherent. Other characteristics, such as patient interaction, patient satisfaction, and prior legal history, appear to be related to physicians themselves, yet they are modifiable if such physicians can be identified. Numerous tools exist that provide general measures of different aspects of EI. Furthermore, identification of those with lower EI and intervention with specific training has been shown to improve both EI and patient satisfaction.

Conclusions and Relevance  The study and effect of EI within medicine offers great opportunity to investigate how physician characteristics may influence one’s EI, as well as medicolegal risk. This review suggests an indirect negative correlation between a physician’s level of EI and his or her risk of litigation. Studies directly linking physicians with low EI to a higher risk of litigation are lacking and may provide valuable insight. Demonstrating such a correlation should prompt the development of interventions that may enhance a physician’s level of EI early in his or her career and may limit future legal action.

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    1 Comment for this article
    Emotional Intelligence, Empathy And Failure To Rescue.
    Peter Shah, BSc MA FRCOphth FRCP Edin | University Hospitals Birmingham NHS Foundation Trust
    I have been running 'Consultant Survival Skills' (CSS) courses for newly-appointed Consultant Specialists in the NHS for 10 years and have had extensive opportunity to observe their performance in role-play conflict situations. Doctors with lower Emotional Intelligence (EI) often exhibit delayed awareness and demonstrable empathy in rapidly escalating conflict situations; with the result that they lose control of the situation. This early loss of control when things go wrong may be one of the factors in 'failure to rescue' and subsequent litigation.
    There are three fundamentals we teach our young Consultant Specialists in CSS:
    [1] Avoid isolation.
    [2] Take
    steps to increase self awareness of EI.
    [3] Embrace team-working and allow others to help you in conflict situations, particularly if your lower EI means that you sometimes need time to get up to speed when things are changing rapidly.