[Arbitration proceedings caused by communication problems].

INTRODUCTION: Functioning communication is one of the basic elements of a trusting doctor-patient relationship. Good medical communication is more important than ever in times of increasing personnel and time constraints. The aim of this study was to examine to what extent medical communication has an influence on the initiation of arbitration procedures.

MATERIAL AND METHODS: The analysis was based on arbitration cases of plastic surgery, which were processed and completed by the Arbitration Board for Medical Liability Issues of North Germany between 2005 and 2015. After eliminating cases with incomplete data, 280 cases were evaluated. The documents were examined for possible communication errors and other triggers of the proceedings. If communication errors were present, these were analysed more closely. Furthermore, it was verified if treatment errors were suggested to patients, e. g. by physicians in charge of aftercare.

RESULTS: 53.6 % of all cases emerged from communication errors in primary care, mainly caused by the attending surgeon (93.7 %). The outpatient follow-up treatment was identified as the most critical period (48.7 %). The most common problem was that patients felt they were not taken seriously (30.9 %). Further aspects were non-availability of the treating doctor (12.2 %), insults or disrespect (8.5 %), inadequate provision of information (8.5 %), and a lack of therapeutic enlightenment (8.1 %). In 43.9 % of the cases, treatment errors were suggested to patients, primarily by the after-treatment physician (70.3 %).

DISCUSSION: The results show that inadequate medical communication has a considerable influence on the overall satisfaction of patients. Statements that appear normal to the surgeon may cause significant emotional reactions in patients. This study shows that arbitration procedures are not only triggered by "real" treatment errors and damage, but also by communication problems. Good communication and empathy help to reduce dissatisfaction and the risk of possible legal disputes.