4 keys to manage medical malpractice stress syndrome

Most physicians will be sued for malpractice during their career. A group at Harvard has estimated that by age 65, more than 75% of physicians in low-risk specialties such as family medicine and 99% of physicians in high-risk specialties such as surgery will have been sued. Over 95% of physicians do experience emotional distress during some or all of the process of litigation. Malpractice suits can take between one to four years to be resolved. If the stress and emotional upheaval associated with a lawsuit is not effectively managed, it can wreck havoc with your health, your relationships, and your practice.

Litigation-related stress is also known as medical malpractice stress syndrome (MMSS). MMSS is not only difficult for the sufferer, but often causes disturbances in their relationships with family, friends, colleagues, and patients. The symptoms of MMSS can come and go throughout the litigation process and can include feelings of intense shame, depression, guilt, and a sense of victimization. Feelings of anger, outrage, frustration, and tension are common. Physical symptoms such as fatigue, GI upset, chest pain, and decreased concentration can also occur. Louise B. Andrew, MD, JD has created a self-assessment for the signs of MMSS. The primary cause of this stress is the perception of a malpractice suit as an attack on our sense of personal integrity — our honor as a physician. For this reason, MMSS can be triggered by a formal complaint or investigation even if it does not result in a lawsuit.

4 keys to managing malpractice-related stress:

First, reach out for support. Your personal physician can be a good resource during this time. Many chronic health conditions are exacerbated by stress and maintaining your physical health is a must. Consulting with a mental health professional should be considered if your distress is interfering with work or relationships, if you are self-medicating with drugs or alcohol, if you are having physical symptoms of stress, or if you have previously experienced an emotional condition that required treatment. Support groups can provide support, education, and coaching on the legal process. There are also good online resources for information and support.

Second, engage in the legal process. It make seem like the last thing you wish to do, but participating actively in your defense will give you more of a feeling of control.

Third, make time for hobbies and activities that you enjoy, exercise, eat a healthy diet, and spend time with friends and family. Self-care is critical during this time.

Fourth, take time to review the successes in your career. The implication of a lawsuit is that the physician was incompetent or careless, and those feelings can be internalized.  Internalizing those feelings can hinder your ability to continue to care for patients and move forward in your career. Looking objectively at the successes in your work will help you to see the incident that occurred more clearly.

Malpractice-related stress is practically inevitable. Fortunately, if you understand that stress is part of the process and take active steps to manage it, you will be able to weather the emotional storm that can come with being sued.

Dianne Ansari-Winn is an anesthesiologist and founder, Transitions Coaching.

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