Medical malpractice actions seek damages following an injury resulting from negligent actions or inactions of a medical provider. Doctors must maintain standards of care in practice. Malpractice occurs when the provider fails to maintain the level of care according to standards that another physician would under similar circumstances.
When a patient fails to adhere to a treatment plan it is referred to as patient non-compliance and it can have dangerous results. According to Health Leaders Media, nearly 30% of prescriptions are never filled and almost half of medications for chronic illnesses are not taken as instructed. Patient non-compliance may cause worsening of illnesses, heightened medical costs, and preventable hospital admissions.
Leading Reasons Patients Fail to Follow Treatment Plans
- Misunderstandings from a language barrier or not comprehending medical terminology
- Denying the severity of the problem, likely involving conditions that minimally impact daily life such as cholesterol or blood pressure
- They cannot afford the treatment, often from a lack of (or insufficient) health insurance or costly co-payments
- Inability or difficulty following directions, such as the intervals in which to take medications
- Fear of pain or side effects, such as postponing a necessary knee operation
- Lack of motivation or willpower
Documenting Patient Non-Compliance
This brings up another key part of any medical malpractice action—proper documentation. Even with today's widespread adoption of electronic health record systems, often touted as making the process of documentation easier, sometimes notes, test results, treatment plans etc. are inadequate. Often communication between physicians who both care for the same patient does not occur, such as between a primary care physician and a specialist, making patient non-compliance less recognizable. Physician's who fail to recognize and document cases of non-compliance can expose themselves to serious liability concerns.
Contributory Negligence in Malpractice
Maryland is a state that recognizes contributory negligence; actually, it is one of only several that have “pure” contributory negligence statutes. This means that in a negligence suit, the plaintiff may be barred from all recovery if they are found to have contributed to their injury. A defendant may prevail in these instances if they can prove that the patient bears full responsibility or shared responsibility that caused the injury. Other states with “pure” contributory negligence laws include Alabama, D.C., North Carolina and Virginia.
Provider Best Practices for Non-Compliance
Non-compliance is one of the few scenarios where a doctor may find that they can no longer risk having an individual as a patient. Other scenarios where this occurs are mainly limited to a failure to pay or a patient demonstrating abusive behavior. For a provider to avoid a possible claim of patient abandonment, medical malpractice, or professional misconduct, the most important factor is written documentation. Physicians must terminate a patient relationship in writing, which contains instructions to continue care elsewhere and the potential consequences of failing to do so. The termination letter is best sent via certified mail with a return receipt available for the patient file.