The impact of being involved in a medical adverse event on GP's (General Physicians) professional behavior in an ambulatory healthcare fund

Orly Manor

Research output: ThesisDoctoral ThesisScientific

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Abstract

Assurance behavior: performing unnecessary tests so as to deter patients from filing complaints or medical malpractice suits
Avoidance behavior: choosing to behave in a way that prevents recurrence of an unpleasant stimulus

This thesis examines the impact of involvement in a medical adverse event on the personal and professional behavior of medical staff or "second victims." The second victim concept is relatively new, and was first described by Albert Wu, M.D., M.P.H in 2000.

The major contribution of this thesis is that it tests the second victim hypotheses in real life settings without the intervention of the medical organization, and examines the methodological and practical challenges involved.
Unlike most studies of this kind that rely solely on self-report questionnaires, especially among care providers in hospitals, the present study tests its hypotheses by measuring real life data.

This study is also unique in that it compares the professional functioning of General Practitioners both prior to and following an adverse event. The theoretical hypothesis was that after involvement in an adverse event, physicians would have a greater tendency to practice defensive medicine expressed through avoidance behavior or assurance behavior, as defined above.

The results reveal that during the month following involvement in an adverse event there is significant impact on a doctor's functioning. This impact may manifest itself in the adoption of defensive medicine and/or avoidance behavior which can be measured by an increase in referrals of patients to the Emergency Room, a tendency to see fewer patients, and a tendency to see patients less frequently.

Recognition of the second victim phenomenon should encourage healthcare organizations to invest resources to support and assist medical staff following involvement in an adverse event, as was the case with the Maccabi Health Care Fund, which decided to implement an intervention program to address this important issue.
Original languageEnglish
QualificationDoctor of Philosophy
Supervisors/Advisors
  • Rijsman, John, Promotor
  • Tal, Y.T., Co-promotor, External person
  • van Dijk, Gerda, Member PhD commission
  • Ash, N.A., Member PhD commission, External person
  • Niv, Y.N., Member PhD commission, External person
  • Todorova, E.T., Member PhD commission, External person
  • Verlinde, V., Member PhD commission, External person
Award date27 Jun 2017
Place of PublicationS.l.
Publisher
Print ISBNs978-94-6167-318-3
Publication statusPublished - 2017

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Defensive Medicine
Delivery of Health Care
Physicians
Medical Staff
Organizations
Malpractice
Self Report
General Practitioners

Cite this

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title = "The impact of being involved in a medical adverse event on GP's (General Physicians) professional behavior in an ambulatory healthcare fund",
abstract = "Assurance behavior: performing unnecessary tests so as to deter patients from filing complaints or medical malpractice suitsAvoidance behavior: choosing to behave in a way that prevents recurrence of an unpleasant stimulus This thesis examines the impact of involvement in a medical adverse event on the personal and professional behavior of medical staff or {"}second victims.{"} The second victim concept is relatively new, and was first described by Albert Wu, M.D., M.P.H in 2000. The major contribution of this thesis is that it tests the second victim hypotheses in real life settings without the intervention of the medical organization, and examines the methodological and practical challenges involved. Unlike most studies of this kind that rely solely on self-report questionnaires, especially among care providers in hospitals, the present study tests its hypotheses by measuring real life data. This study is also unique in that it compares the professional functioning of General Practitioners both prior to and following an adverse event. The theoretical hypothesis was that after involvement in an adverse event, physicians would have a greater tendency to practice defensive medicine expressed through avoidance behavior or assurance behavior, as defined above. The results reveal that during the month following involvement in an adverse event there is significant impact on a doctor's functioning. This impact may manifest itself in the adoption of defensive medicine and/or avoidance behavior which can be measured by an increase in referrals of patients to the Emergency Room, a tendency to see fewer patients, and a tendency to see patients less frequently. Recognition of the second victim phenomenon should encourage healthcare organizations to invest resources to support and assist medical staff following involvement in an adverse event, as was the case with the Maccabi Health Care Fund, which decided to implement an intervention program to address this important issue.",
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The impact of being involved in a medical adverse event on GP's (General Physicians) professional behavior in an ambulatory healthcare fund. / Manor, Orly.

S.l. : [s.n.], 2017. 104 p.

Research output: ThesisDoctoral ThesisScientific

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N2 - Assurance behavior: performing unnecessary tests so as to deter patients from filing complaints or medical malpractice suitsAvoidance behavior: choosing to behave in a way that prevents recurrence of an unpleasant stimulus This thesis examines the impact of involvement in a medical adverse event on the personal and professional behavior of medical staff or "second victims." The second victim concept is relatively new, and was first described by Albert Wu, M.D., M.P.H in 2000. The major contribution of this thesis is that it tests the second victim hypotheses in real life settings without the intervention of the medical organization, and examines the methodological and practical challenges involved. Unlike most studies of this kind that rely solely on self-report questionnaires, especially among care providers in hospitals, the present study tests its hypotheses by measuring real life data. This study is also unique in that it compares the professional functioning of General Practitioners both prior to and following an adverse event. The theoretical hypothesis was that after involvement in an adverse event, physicians would have a greater tendency to practice defensive medicine expressed through avoidance behavior or assurance behavior, as defined above. The results reveal that during the month following involvement in an adverse event there is significant impact on a doctor's functioning. This impact may manifest itself in the adoption of defensive medicine and/or avoidance behavior which can be measured by an increase in referrals of patients to the Emergency Room, a tendency to see fewer patients, and a tendency to see patients less frequently. Recognition of the second victim phenomenon should encourage healthcare organizations to invest resources to support and assist medical staff following involvement in an adverse event, as was the case with the Maccabi Health Care Fund, which decided to implement an intervention program to address this important issue.

AB - Assurance behavior: performing unnecessary tests so as to deter patients from filing complaints or medical malpractice suitsAvoidance behavior: choosing to behave in a way that prevents recurrence of an unpleasant stimulus This thesis examines the impact of involvement in a medical adverse event on the personal and professional behavior of medical staff or "second victims." The second victim concept is relatively new, and was first described by Albert Wu, M.D., M.P.H in 2000. The major contribution of this thesis is that it tests the second victim hypotheses in real life settings without the intervention of the medical organization, and examines the methodological and practical challenges involved. Unlike most studies of this kind that rely solely on self-report questionnaires, especially among care providers in hospitals, the present study tests its hypotheses by measuring real life data. This study is also unique in that it compares the professional functioning of General Practitioners both prior to and following an adverse event. The theoretical hypothesis was that after involvement in an adverse event, physicians would have a greater tendency to practice defensive medicine expressed through avoidance behavior or assurance behavior, as defined above. The results reveal that during the month following involvement in an adverse event there is significant impact on a doctor's functioning. This impact may manifest itself in the adoption of defensive medicine and/or avoidance behavior which can be measured by an increase in referrals of patients to the Emergency Room, a tendency to see fewer patients, and a tendency to see patients less frequently. Recognition of the second victim phenomenon should encourage healthcare organizations to invest resources to support and assist medical staff following involvement in an adverse event, as was the case with the Maccabi Health Care Fund, which decided to implement an intervention program to address this important issue.

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