The Psychological Costs of a Malpractice Suit*
by Wayne M. Sotile, Ph.D. & Mary O. Sotile, M.A.

*This article was originally published by Physician Money Digest.

One in three physicians practicing today will be sued for malpractice at least once during the course of their careers. For surgeons, those figures climb to between 50% and 60%.
The financial costs of preparing and defending oneself against malpractice can be formidable and may include lost clinical time and income, unexpected legal fees, and insurance coverage or practice privilege consequences. These financial strains are difficult to endure. But too often physicians and their families pay an incalculable cost in the wake of a malpractice suite: disillusionment with the practice of medicine. As the following comments indicate, this “post-malpractice syndrome” can lead to bitterness, distrust, depression, and premature withdrawal from medical practice.

Wife of Dr. X: “After all my husband has done for his patients, I can’t believe that this is happening. He has sacrificed his health, our family life, and most of his joy for the sake of being a good physician. This money-hungry patient is damaging the soul of a good man. I wish that he would close his practice. This is simply not worth it.”

Dr. X: “I have to admit that things have been different since I went through that ordeal. My name has been in the local papers six times over an 18 month period, and each time the silence from the other physicians in my practice has been deafening.

“These days, I find myself holding back more -- both in my dealings with patients and other physicians. Hey, the money I’m losing is recoverable. What seems to be gone for good is the unbridled joy I used to feel about practicing medicine and my faith in the ‘fraternity’ that I thought my colleagues and I were.”

What Matters Most
Physicians report that the support from family and from colleagues are the two most crucial aspects of coping with the emotional consequences of a malpractice suit. Our experiences as therapists to physicians suggest guidelines that can help ease the sting of this ordeal and prevent the ultimate “costs” --- burnout and dropout.

• See a malpractice suit as a relationship-building opportunity. When a physician is sued, his or her relationships at home and work are either enhanced or damaged. This is due to a simple fact: crisis is a “learnable” moment; a time when the person in crisis is impacted by the behavior of others. When support and compassion are offered, the relationship emerges from the crisis stronger than ever. But blame, shame, or silence will likely damage your relationship in ways that endure even once the malpractice suit is settled.
What to do: If you are being sued, let loved ones and colleagues know that you need and would appreciate their support. If you are the colleague or loved one of someone on the litigation hot seat, proactively offer support. A simple statement like “I heard about what’s happening. I want you to know that I’m pulling for you” can generate goodwill that lasts a lifetime.

• Accept that this is a family affair. While the doctor is the “identified patient” in a medical malpractice suite, but the family, too, is affected. How loved ones define the causes and consequences of this event will directly determine their coping teamwork. As you move forward, you and your family must develop a common frame of reference. If one of you decides that the suit signals the end of tolerance for the stresses of a medical life, and the other concludes that a malpractice suit is simply part of the business of medicine, you will be at odds with each other when you most need mutual support.

What to do: Talk about it. If necessary, get counseling from someone who respects and understands the unique challenges of a life in medicine.

• Manage yourself. Feelings like guilt, shame, and humiliation are natural in the aftermath of any denting of the “superperson syndrome” that medical training perpetuates.
What to do: Work to develop philosophies that protect your self-worth and that help heal you when you are hurt. Have faith that this, too, shall pass. It might help to recall that some of history’s greatest performers also “failed” regularly. Babe Ruth set two noteworthy records: for most home runs and most strike-outs; Michael Jordan took and missed far more potential game-winning last shots than he made. When you play in the majors, your losses are a matter of public scrutiny.