Many emergency physicians (EPs) named in lawsuits are emotionally derailed by the process, and experience anxiety, frustration, and insomnia as a result. “Emergency physicians are at higher risk of burnout, depression, and suicide compared to the general population. Increased stress associated with a lawsuit could exacerbate this risk,” says Melanie Heniff, MD, JD, MHA, FAAEM, FAAP, associate professor of clinical emergency medicine and pediatrics at Indiana University (IU) School of Medicine.
Adding to the EP’s isolation are attorneys’ instructions to avoid discussing the case with anyone, since conversations are potentially discoverable in court. Unfortunately, the stigma of being sued for malpractice keeps some EPs from seeking professional help for mental health concerns. “Physicians may also avoid seeking treatment from a therapist or psychiatrist because of fears that a mental health diagnosis could lead to restrictions on their hospital privileges or medical license,” notes Heniff.
During the COVID-19 pandemic, the IU Department of Emergency Medicine offered peer support sessions for frontline physicians. “During these sessions, our team realized there was a need for peer support specifically geared towards physicians who were currently experiencing medical malpractice lawsuits,” reports Marla C. Doehring, MD, an associate professor of clinical emergency medicine at IU School of Medicine. An attorney from IU Health’s risk retention group worked with EPs to implement a group-based peer support program.1 The group contacted 28 EPs and non-physician ED practitioners who were defendants in active lawsuits. The 17 EPs who agreed to participate met for monthly remote sessions led by trained facilitators. “Physician participants joined the sessions remotely from many different hospitals and areas of the state. Remote meetings allowed more physicians to participate,” explains Doehring. The EPs discussed emotions, coping strategies, and general legal processes (such as depositions), while avoiding specifics of their malpractice cases.
Many EPs reported symptoms of acute distress and medical malpractice stress syndrome. “Younger physicians and those enduring their first lawsuit seemed to be disproportionately impacted when they were named in a lawsuit. Guilt, anger, frustration, and self-doubt were some of the emotions that were commonly discussed, especially by less experienced colleagues,” says Doehring.
Almost all (96%) participating physicians reported feeling better after peer support sessions. Notably, burnout did not worsen in participants during the study period.1
“By acknowledging that lawsuits are a potential occupational hazard in the medical field, especially for high-risk specialties, emergency physicians and advanced practice providers can focus on learning from the experience, rather than being consumed by fear or defensiveness,” says Christian C. Strachan, MD, MBA, executive vice chair of clinical affairs in the Department of Emergency Medicine at IU School of Medicine.
EPs familiarize themselves with legal processes, obtain continuing education on risk management, and collaborate with legal experts to mitigate liability risks. “This proactive approach can enhance physicians’ confidence in navigating legal challenges. It can minimize the potential impact on their professional reputation and livelihood,” offers Strachan.
REFERENCE
- Doehring MC, Strachan CC, Haut L, et al. Establishing a novel group-based litigation peer support program to promote wellness for physicians involved in medical malpractice lawsuits. Clin Pract Cases Emerg Med 2023;7:205-209.
Many emergency physicians (EPs) named in lawsuits are emotionally derailed by the process, and experience anxiety, frustration, and insomnia as a result.
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