A psychiatrist from the University of Miami reported at the AAPM meeting that patients with chronic pain conditions are more likely to sue their physician for malpractice than patients without pain or acute pain only. This finding came from a study of over 2,200 patients and healthy individuals. Patients with both acute and chronic pain were more likely than those without pain to agree with hostile wish statements on a questionnaire. This hostility may be intensified in chronic pain patients, as they are often forced to see physicians against their will if it's a matter of worker's compensation litigation; this means they perceive the physician as being on the other side in their dispute.

The psychiatrist, Dr David Fishbain, said that "While we don't know if these patients will take you to court or kill you, we do know that healthcare workers are at a significant risk for patient perpetrated violence." In the healthy individuals' responses, about 1.58% expressed the hostile wish to kill their doctor, while 1.5% had the urge to sue. Acute pain patients under worker's comp claims were 5 times more likely to have a wish to kill their doctor than a health person, and were 3 times more likely to sue; but chronic pain patients were slightly less likely to have a death wish, but 4 times more likely to sue.

It's important that full use is made of referrals to pain specialists, who can often defuse these hostile emotions. We don't want to lose too many doctors to this trend. What do you call doctor-killing by a patient? Not "medicide" anyway.