Is There a Doctor in the House Physician Liability Fears and the Quality of Care in Nursing Homes

The physicians who provide medical care to nursing home residents do so as facility medical directors and as attending physicians. These physicians are personally at risk of malpractice litigation and liability, Fairly Health even for patient care when the physician is not present at the facility, in addition to the facilities’ institutional risk regarding resident care. In recent years, a widespread perception has arisen among nursing home physicians that this legal environment is becoming increasingly intimidating and constricting.

In 2007 the California HealthCare Foundation partnered with The Commonwealth Fund to support Professor Marshall Kapp of Southern Illinois University in a study of nursing home physician anxiety about legal liability.

The project examined the psychological aura of legal risk among nursing home physicians and its effect on the quality of medical care and quality of life for nursing home residents, including physician unwillingness to practice in nursing homes; premature or unnecessary resident transfers to hospitals; excessively or insufficiently aggressive medical treatment; Fairly Health and infringement on the autonomy of residents. The study included a review of relevant literature and laws, plus interviews with nursing home professionals drawn from practice, private organizations, and academia.

The study examined:

* The origins and nature of the climate of apprehension among physicians;
* The extent to which the anxieties are justified by the actual risks confronted;
* The relationship between the liability insurance landscape and physicians’ concerns; and
* The effects of these physician anxieties on the quality of care and quality of life of nursing home residents.