Wednesday, November 23, 2005

Coping with a medical malpractice suit

Dear Madhouse Madman is served with a complaint. My heart goes out to him! Sara Charles, MD, describes the devastating impact of litigation on physicians:
The reaction to being sued often is prefaced by a period of emotional turmoil following the catastrophic event or negative outcome. The physician may feel unduly responsible or guilty, genuine sorrow for the persons involved, dread, anxiety, and fear of being sued. These feelings may not resolve in any way until the statute of limitations expires or a suit is filed.

More than 95% of physicians react to being sued by experiencing periods of emotional distress during all or portions of the lengthy process of litigation. This may begin immediately on being served with the complaint by a sense of outrage, shock, or dread about the personal and financial effects of the eventual outcome. This is the first reaction in a series that is similar to those that accompany any major life event...Feelings of intense anger, frustration, inner tension, and insomnia are frequent throughout this period.

Symptoms of major depressive disorder (prevalence, 27%-39%), adjustment disorder (20%-53%), and the onset or exacerbation of a physical illness (2%-15%) occur, although fewer than 2% acknowledge drug or alcohol misuse. A general internist, for example, described awakening with his first episode of atrial fibrillation after being served with his first malpractice suit the previous afternoon. This generated emergency medical consultation accompanied by profound psychological effects on the physician. Some 2 years later, it figured prominently in his decision to settle and to retire earlier than he had originally planned...
Symptoms may develop during any of these stages when adequate coping fails:
The complaint is served: initial feelings of surprise, shock, outrage, anxiety, or dread

Consultation with lawyer: depending on the initial assessment of the case, reactions of anger, denial, concern, reassurance, panic

Lengthy period of denials and intrusions: active attempts to erase thoughts about the case, followed by automatic reminders and intrusive thoughts about it; becoming preoccupied by ruminating excessively—exacerbated whenever case-related activity increases, such as before the deposition, when experts testify, and before and during the trial

Working through the lengthy process, during which physicians psychologically and intellectually “process” the meaning of the case, their role in it, and their approach to their own defense...

6 Comments:

Blogger Kim said...

Just thinking about being sued, as an RN, makes me shaky.

The sad thing is that just because a suit is filed, it doesn't mean that the doctor did anything wrong.

Hah...I'd like to see a doctor who is cleared of malpractice file a counter-suit for intentional infliction of emotional distress. No, nevermind. It just gives more business to the lawyers.

Tort reform and damage limits, anyone?

2:03 AM  
Anonymous Anonymous said...

Weirdly enough, if you substituted "doctor" for "lawyer" in most of that article, you'd pretty much have the reaction of non-medical people to dealing with illness, or even a simple doctor's visit.

Or just about any other stressful issue.

No one wants to be sued wrongfully or maliciously, of course. And no doubt doctors by the nature of their practices are in danger of such suits more than the rest of us. There medical folks have my sympathy.

But I'm not sure why these reactions or feelings about being sued for malpractice should surprise anyone in any way.

11:11 AM  
Blogger Rita Schwab - MSSPNexus said...

I've always believed that the profession of healthcare attracts the best and the brightest.

Being named in a malpractice action is the ultimate criticism for someone whose life's work is all about healing.

Sometimes we get tangled up in the facts and figures and forget that real human emotion is involved on both sides of every legal case.

Rita
http://msspnexus.blogs.com/

1:07 PM  
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5:52 AM  
Anonymous Anonymous said...

I completely agree with the anonymous person who said that you can substitute any of the physician's feelings listed above for the patient's feelings or the feelings of the patient's lawyer---surprise, shock, outrage, anxiety, dread, etc. I was at this point in the late 1990's because of an incompetent neurosurgeon I had. Due to my family, (none of whom have ever been employed in the medical profession), taking me to a completely different hospital in a completely different geographical area, I am fully functional today. But I lost an extremely good job I had recently acquired while I was waiting for the clown to diagnose me properly, and I've never been able to get another job as good since then. :( I wasn't able to invoke the Medical Leave Law in order to save my job, because I hadn't been with the company long enough. And, several months after I was successfully operated on at the second hospital, the first neurosurgeon's billing dept. phoned me and threatened to turn my account over to a collection agency if I didn't pay the money I owed him---$800 !!! (His bills had fallen under my insurance deductible). Never mind that I'd lost my job while I was waiting for him to diagnose what turned out to be a **pre-existing* condition I'd had problems with 20+ years before! (And, yes, the condition I have is a neurological condition that he should easily figured out.)

7:01 PM  
Blogger Dr John Crippen said...

Where the USA is now the UK will follow....

I read the blogs about litigation in the USA with increasing foreboding. UK physicians are rarely sued, but the incidence is ever increasing as are the insurance premiums.

And so often now, the litigation is a knee jerk reaction to a perceived problem along the lines... "Granny died, so there must have been a mistake..."

We (USA & UK) need to move to a no fault compensation system, similar to what is developing in Australia.

In a famous English case, a child was brain damaged during a traumatic birth. The parents sued. The case hinged on a simple question: did the registrar (senior resident) pull too long and/or too hard on the forceps. At first instance, he did; on appeal the finding was overruled and it was decided he did not.

So, no compensation for the child. 3 years grief for the obstetrician. Only the lawyers made money.

If a reasonable level of compensation was paid to patients who sustain unexpected damage, without consideration of fault, who would lose.........except the lawyers?

5:14 PM  

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