The Emerging Discipline of “Slow Medicine” and Professional Liability

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Examining the Heuristic Relationship between Face-Time and Medical Negligence Lawsuits 

By Dr. David Edward Marcinko MBA CMP™


Our colleague and blogger Kent Bottles MD has been thinking and posting about the emerging philosophy of “slow medicine”. Of course, health economists realize how complex and difficult it is to transform American health care so that we will enjoy lower per-capita costs along with increased medical care quality in our lives. Unfortunately, grass root practitioners have done just the opposite these last two decades or so. In other words, practicing “faster medicine” with assembly line efficiency relegating office visits to 15, 10 or even 7 minute increments etc, in order to compensate for diminishing MCO/HMO reimbursement. And, this may have been a financially acute perspective for modernity until now!

Defining the Obvious

Slow medicine is practiced by a small, but growing subculture whose pioneer and spokesperson is Dr. Dennis McCullough, author of the book My Mother, Your Mother [Embracing “Slow Medicine,” The Compassionate Approach to Caring for Your Aging Loved Ones].

In other words, slow medicine is a philosophy and set of practices that believes in a conservative medical approach to both acute and chronic care. However, I believe there may be more to it than first perceived.


My Experiences

After serving as a medical expert witness in hundreds of malpractice cases [consulting, chart review, discovery depositions, trial appearances and sworn testimony] – both directly and indirectly and for both plaintiff and defendant doctors [predominately] – thru almost twenty year of private practice, my gut tells me the following:

“Patients do not sue doctors they personally like – they do sue doctors they do not like.”

In my opinion and experience, great clinical doctors are often sued while their lesser adept souls are not. Moreover, I believe this pleasing reduced liability relationships is enhanced by more patient face-time; not less. This is not a function of competency, but one of human relationships and “connectedness” with one’s caregiver. It will not be changed by eMRs, or more diagnostic tests [malpractice phobia] or procedures. It will be improved by intense physical examination, touching, eye contact, sympathy, empathy and time [aka: a TRUSTING relationship and pleasing bedside manner forged by TIME]. Period!

And so, for our business managers, CEOs and medical executive readers, let us compromise on terminology and call it “slower medicine.”




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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact:


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5 Responses

  1. Dear David,

    You did a wonderful job presenting the benefits of “slow medicine.” I completely agree with the philosophy for my own dental practice – not only for building trusting relationships with friends who are unlikely to sue me, but for providing my best work for friends I hope to see every six months for the rest of my career. As a matter of fact, about 20 years ago, I adopted an unprecedented and perhaps gutsy slogan for my dental practice based on the slow medicine philosophy – “Dentistry Unhurried.”

    Though I suffered ribbing from a colleague who taunted, “Yeah! That’s what I want: A slow root canal,” there seems to be lots of people in the Fort Worth area who have experienced the pain of fast injections, and are attracted by the care I promise. Dentistry consists of intricate handwork in unpredictable mouths attached to patients who are sometimes anxious. Doing dentistry in a rush is no fun for anyone.

    Dentistry Unhurried is the only way I ever want to work – even if it doesn’t make me rich in money.

    Darrell K. Pruitt DDS


  2. Better People – Better Doctors

    Excellent post Dr. Marcinko, and comment Dr. Pruitt. How simple and true!

    Here is another link for you review on how doctors can reduce malpractice by being better people



  3. Medical-Liability Bill Approved by House Committee

    Members of the House Judiciary Committee just voted 18-15 to approve the medical liability reform bill that physician Phil Gingrey (R-GA) introduced late last month. Picking up where they left off last week, committee members considered the remainder of numerous Democrat-sponsored amendments to the tort-reform bill known as the Help Efficient, Accessible, Low Cost, Timely Healthcare—HEALTH—Act of 2011, and accepted only one.

    That measure, sponsored by Rep. Bobby Scott (D-VA), strikes the section of the bill that says in any healthcare lawsuit involving injury or wrongful death, any party may introduce evidence of “collateral source benefits,” or compensation from other sources. Ultimately, the law would limit non-economic damages to $250,000 and makes each party liable only for the amount of damages that is directly proportional to that party’s percentage of responsibility.

    Source: Jessica Zigmond, Modern Healthcare [2/17/11]


  4. SLOW Healthcare Change



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