What patient attributes are associated with thoughts of suing a physician?

To address a neglected research area: the attributes of rehabilitation patients associated with "thoughts of suing a physician" (S-MD).

The S-MD statement "I am thinking about suing one of my doctors" was administered to 2264 people, along with the Battery for Health Improvement (BHI 2). Items predictive of S-MD were identified.

Acute physical therapy, work hardening programs, chronic pain programs, physician offices, and vocational rehabilitation programs.

Participants included 777 rehabilitation patients and 1487 nonpatient community-dwellers.

Not applicable.

We used a multivariate analysis of variance to determine which of the 18 BHI 2 scales predicted the S-MD statement. Items from the scales found to be predictive, plus other variables, were then used in a chi-square analysis that compared people who wished to sue with those who did not. We then used a stepwise regression analysis with significant items from the prior analyses to build a model for predicting a potential S-MD patient.

The highest percentage (11.5%) of patients affirming the S-MD statement were those involved in workers' compensation and personal injury litigation, compared with only 1.9% of community-living subjects. Stepwise regression of BHI 2 variables produced a 13-variable model explaining 38.04% of the variance. A logistic regression of demographic variables (eg, education, ethnicity, litigiousness) explained 20% of the variance.

Anger (P<.001), mistrust (P<.001), a focus on compensation (P<.001), addiction (P<.001), severe childhood punishments (P<.001), having attended college (P<.001), and other patient variables were associated with thoughts of suing a physician.