Medical litigation. The aetiological role of psychological and interpersonal factors

The present paper focuses upon psychological factors which may cause patients to make formal complaint or embark upon legal proceedings against a doctor despite competent medical management. Although the principles involved arose from experience of liaison psychiatry in neonatal and obstetric settings, they are more broadly applicable to other areas of medical practice. The corner stone of prevention is appropriate psychological management. One of the most common forms of psychological mismanagement is a failure to share information openly with patients when it becomes available. Sometimes, despite exemplary medical and psychological management, grievance proceedings are still initiated. Often in such cases the cause lies in the patient's psychopathology. Finally, formal complaint or litigation may arise as a result of the patient's unrealistic expectations of the doctor.