The stages of grief when a physician is sued

It’s hard to describe the feelings I had when I received my first letter of intent to sue. I think I went through the Kubler-Ross stages of grief — denial at first, of course. This denial didn’t last long since the letter was clearly addressed to me — first, middle, and last name.

Anger was almost immediate … I was immediately upset at the deceased patient’s family who were bringing the lawsuit; I automatically considered them selfish and money-hungry, I criticized our health care system that allows for seemingly frivolous lawsuits, I hated all lawyers and considered them evil.

I skipped the bargaining step, but within an hour of receiving this letter, I was already sinking into a depression. I started thinking that I must be an awful doctor — I had only been in practice for about three years when this letter arrived.

Some doctors practice for years and never get sued. I started questioning my decision to go into medicine. I thought about the hurdles I had been through to get my MD, complete residency, and get board certified.

I started thinking that maybe it wasn’t a good decision. Maybe I would be happier doing something else — anything else.

I started to hate going to work. I started to see patients, not as an opportunity to make a positive change in someone’s life — but instead, I started triaging patients based on who seemed like the type to sue.

I started to practice medicine defensively. I started ordering more tests. I started consulting more specialists. I started to cut conversations with patient’s shorter so I would have more time to document every last detail that was spoken during an encounter. I started to see my profession and my career as a job and not a calling.

This first letter of intent to sue never went anywhere.

Since this letter, I have been served papers, as my name was again brought into a lawsuit, and after about a year of correspondence with my malpractice carrier and the lawyers they referred me to, my name was dropped.

Once again, last week, I received another letter of intent to sue. Since this is my third letter, it seems like it should be easier. I should know the drill by now, but it’s not easier.

Every time this happens, I go through all of the same feelings once again — mostly anger and depression. And the questioning. Every time it happens, I question my decision about going into medicine. And then, I read stories about physicians who don’t practice clinical medicine anymore. I read statistics stating that half of current physicians, if given the choice again, would not choose medicine as their occupation.

Somehow, I don’t think I’m alone.

I’m sure that when patients or their families bring lawsuits, they have good reason in their minds. Being on the other side of this lawsuit, this reason is rarely clear to me. I’m almost sure that these patients and families don’t know what a lawsuit does to all doctors.

Whether the lawsuit is frivolous or not, the feelings are the same. Anger. Depression. Questioning. And then the outcome — defensive medicine.

Ordering more tests. Consulting more specialists. Taking less time talking to patients and more time documenting everything said. This is not how health care needs to be.

I’m not sure I’ll ever be able to complete the Kubler-Ross stages of grief with acceptance. Honestly, even with these challenges in medicine, I still enjoy what I do for a living. The science is interesting. My patients are my teachers. I love to read about mechanisms of disease and about new medications on the market. I like figuring out the reason for the problem. I work hard to do the best job I can. I care. For that reason, I can’t accept the accusation of “negligence.”

The author is an anonymous physician.

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