Poor Unlikely to Sue for Malpractice, Study Finds : Medicine: Researchers say their facts explode a myth that contributes to doctors’ reluctance to treat the uninsured.

Contrary to the opinion of many doctors, the poor and uninsured are less likely than well-off patients to sue for malpractice, according to a study by Arizona State University and Harvard University researchers published today in the Journal of the American Medical Assn.

The finding, based on the examination of 31,000 patient records in New York, casts doubt on the rationale sometimes cited in the refusal of doctors to treat poor and uninsured patients. Huge amounts of paperwork required by government agencies for Medicaid patients and low reimbursement rates are also cited as reasons for physicians not treating the poor.

Dr. Helen R. Burstin of the Harvard-affiliated Brigham and Women’s Hospital in Boston, who led the team of researchers, said one purpose of the study was to explode what she said was the myth that poor and uninsured patients are litigious and to focus more attention on other factors.

“I think the real reason people aren’t taking care of poor patients is compensation,” she said.

Poor patients in the study brought malpractice suits only 10% to 20% as often as middle- and upper-middle-class patients.

“Our results suggest that rather than suing more frequently, poor and near-poor patients are far less likely to sue,” the researchers said.

An editorial accompanying the article said the results “are not surprising.” The editors of the magazine said the researchers “expose another persistent myth about medical malpractice. It is commonly believed that poor patients are more likely than wealthier patients to bring malpractice claims.”

In addition, the researchers said attorneys are reluctant to take on the poor as clients because they expect that monetary recoveries will be low since malpractice awards are usually based on the client’s future earning power.

The findings, in general, did not surprise state and local health authorities in California.

Dr. Roger Hoag, a Berkeley-based obstetrician/gynecologist, said a study of California Medi-Cal patients found that they were less likely to file malpractice suits than more affluent patients. The study was sponsored by the American College of Obstetricians and Gynecologists, a branch of medicine that has been cited frequently for refusing treatment to the poor and uninsured.

Melinda Bird, an attorney with the Western Center on Law and Poverty in Los Angeles, said, “It’s absolutely our experience that poor people are unable consistently to exercise their legal rights as well as middle-class and upper-middle-class people. Just think who is more likely to get in to see a lawyer.”

Bird said the legal system of monetary damages was based on the value of a person’s life and potential earning power. “Attorneys have told me, ‘I won’t look at this case because the amount I get for wrongful death is not worth it.’ That is the very brutal calculus that private personal injury attorneys make,” she said.

Burstin noted that in the debate going on in Washington over President Clinton’s proposed health reform plan there are suggestions that a cap be put on contingency fees, which she said “could hurt poor patients even more.”

Burstin was joined in the project by William G. Johnson, an economist with the School of Health Administration and Policy at Arizona State University.