“You have been served!” What is litigation stress, and how do you handle this stressful situation?
Allison M Fernandez, MD MBA, Christopher Conley, MD, Malgorzata "Gosia" Lutwin-Kawalec, MD, Rich Elliott, MD
Many of our readers have asked for the PAAD to include podcasts and to establish an increased social media presence. We’ve heard you and have assembled a team led by Drs. Debnath Chatterjee and Sean Barnes to facilitate this change. In today’s PAAD, Dr. Allison Fernandez and her colleagues present both in our usual PAAD print format and in a simultaneously posted podcast, a discussion of physician’s experiences with being sued for medical malpractice. In the podcast, Allison interviews an emergency department physician Dr Gita Pensa, who hosts a fantastic podcast resource Doctors and Litigation: The L Word Podcast…at Allison’s urging I listened to season 1 and found it both entertaining and incredibly informative. I think many of you will agree. Finally, I would urge all of you to read today’s PAAD in its traditional format and to listen to the accompanying podcast and let me know what you think. This will help me and the executive council of the PAAD as we move forward this new format. And one more thing….litigation and medical malpractice was a topic for near and dear to the late Dr. Ron Litman who started the PAAD and in whose memory we keep it alive. Indeed, when Ron was alive a review of a medical malpractice suit was a regular feature of the PAAD. Myron Yaster MD
“You have been served!” Being served a subpoena is an event that no physician ever wants to experience. As physicians, we focus on providing evidence-based, compassionate care with safety at the forefront. However, there are times when patients experience a poor outcome and decide to sue. Most physicians are ill-equipped to deal the the plethora of emotions and stressors that come with the often drawn-out litigation process. Physicians who are unfortunate to experience a lawsuit are dealing with a wide range of emotions and have limited options for coping with or sharing their associated feelings or stressors. They are often advised or outright told that they cannot discuss these with anyone besides legal counsel or risk management. That imposed isolation only serves to compound the negative emotions impacting physicians involved in a lawsuit.
In her excellent podcast, “Doctors and Litigation: The L Word,” Gita Pensa, MD ( Doctors and Litigation: The L Word Podcast - Apple Podcasts) recounts physicians’ experiences with the litigation process. The feelings described are inadequacy, self-doubt, frustration, fear, guilt, sorrow, anger, incompetence, shame, and sadness. These distressful feelings can become destructive both physically and psychologically and are known as “litigation stress.” Physicians with litigation stress are at risk of anxiety, depression, suicide, and isolation, and it negatively impacts their relationships with their spouses, partners, children, friends, and colleagues. Litigation stress can be managed through several avenues such as self-education, safe space discussions as well as accessing and utilizing the numerous resources available in various formats and venues. We need to learn and understand the litigation process to reduce our anxiety about the enigma of litigation. We also have to create space to talk about our feelings throughout the litigation process to prevent isolation.
There are many resources available for physicians experiencing litigation stress. Here are resources that may help you learn to deal with litigation stress on the SPA website: https://pedsanesthesia.org/physician-litigation-support-resource-list/
A recent article published in December 2024 ASA Monitor called “Help, I’ve Been Sued! A Practical Guide to Dealing with a Lawsuit”, Drs. Chi, Primm, and Singh provide a “guided tour” of a lawsuit, with “Dos” and “Don’ts,” in order to demystify the process and mitigate the litigation stress. Another great resource is the ASA’s Safe Haven, a counseling program for physicians dealing with stress and mental health challenges (https://www.asahq.org/advocating-for-you/safehaven).
Reference and Resources
Doctors and Litigation: The L Word by Gita Pensa MD ( Doctors and Litigation: The L Word Podcast - Apple Podcasts
Chi, Jason Sung MD; Primm, Aaron N. MD, FASA; Singh, Naileshni S. MD. Help, I've Been Sued! A Practical Guide to Dealing with a Lawsuit. ASA Monitor 88(12):p 20-21, December 2024.
SPA Website Litigation Support
https://pedsanesthesia.org/physician-litigation-support-resource-list/
ASA Safehaven Program