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Lawsuit Does Not Change Physican Approach to Patients

Patients just as likely to play role in screening decision, even after lawsuit on shared decision making

TUESDAY, March 27 (HealthDay News) -- Physicians in a Virginia practice continued to share decision-making with patients even after a member of the practice was successfully sued by a prostate cancer patient who had declined prostate-specific antigen testing. The findings are published in the March/April issue of the Annals of Family Medicine.

Alex Krist, M.D., and colleagues from Virginia Commonwealth University in Fairfax, Va., analyzed data from an ongoing randomized, controlled trial of patient-physician prostate screening discussions. During the study, a physician was successfully sued at the practice after allowing a patient to make his own decision about screening.

Using patient and physician questionnaire responses, the investigators found that patients were just as likely to report having a say in their decision before, during and after the lawsuit (91, 87 and 90 percent, respectively). However, after the lawsuit, physicians were more than three times as likely to say they made the final decision about screening (3.3 percent before, 11.1 percent after). Prostate-specific antigen testing increased by 6 percent, though national rates stayed the same during that time.

"At least in this limited setting of patient-physician discussions of prostate-specific antigen screening, our data on the shared decision-making process do not support the premise of defensive medicine -- that the threat or experience of adverse litigation will alter clinician behavior," the authors write.

Krist is a partial owner of a family practice residency where the study was conducted.

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