Abstract for: Understanding Public Trust in Healthcare Services and Doctor-Patient Relationship in the Contexts of Medical Errors

Medical malpractice lawsuits in Thailand have been increasing, and often leading to conflicts among stakeholders that could deteriorate doctor-patient relationship and the public trust in healthcare services. To address this complex problem, we report on a systems thinking approach to developing a mutual understanding among stakeholders on the causes of deteriorating trust in healthcare services in the contexts of medical errors. Group model building sessions were conducted with participating stakeholders from various organizations in Thailand (n=20), including policymakers, administrators, healthcare providers, advocates of patient rights, and victims of medical errors. The initial causal loop diagram was mutually created, then was reviewed and elaborated by community leaders and experts in patient safety and health systems development. The final model consists of four domains: medical errors and malpractice lawsuits, roles of the third-party beneficiaries in medical lawsuits and the conflicts presented on mass and social media, the people’s trust of healthcare services, the healthcare quality improvement efforts. Our findings provide an insight of potential high-leverage points for reducing medical errors, improving public trust in healthcare services, and strengthening doctor-patient relationship in Thailand. One of the emerging policy recommendations was to change the existing law towards a balance of monetary and non-monetary remedies for victims of medical errors.