Medical Malpractice lawsuit = shoddy medical care + something else

I’m currently reading Blink: The Power of Thinking Without Thinking by Malcolm Gladwell.  The book takes a look at snap judgments and what we do in an instant.  Gladwell also compares snap decisions with slow analytical decision making.  He leads with an example of a sculpture.  All the evidence, such as testing the material, shows that the sculpture is authentic.  This is contrasted to a group of experts that immediately thought something was wrong.  They couldn’t put their finger on it, but something didn’t seem right.  The first word that popped into the mind of one of the experts was “fresh.”  Which way is more accurate?  After a year of testing it was determined that the sculpture was in fact a fake.

Besides being a good storyteller, Gladwell discusses the likelihood of a doctor getting sued for medical malpractice.  He gives the example of you, the reader, working for a medical malpractice insurance company.  You’re given two choices to decide how prone a doctor is to committing medical malpractice:  1) Do you examine the doctor’s training and previous records to see how many errors they’ve made over the last few years? Or 2) Listen in on a brief conversation between the doctor and a patient?

According to Gladwell, listening in on the doctor/client interaction is much more predictive than where the doctor went to school and how error prone he/she is:

Analyzes of malpractice lawsuits show that there are highly skilled doctors who get sued a lot and doctors who make losts of mistakes and never get sued.  At the same time, the overwhelming number of people who suffer an injury due to the negligence of a doctor never file a malpractice suit at all.  In other words, patients don’t file lawsuits because they’ve been harmed by shoddy medical care.  Patients file lawsuits because they’ve been harmed by shoddy medical care and something else happens to them.
(underlining added).

Gladwell states that the something else is the human interaction element.  How was the patient treated on a personal level?  In other words, people don’t sue doctors they like.