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.


  • Steven Reznick

    In states where there are no caps on non economic damages, the upside is so great that law firms can take cases that are not sure things. The resultant frivilous suits take years to complete, are expensive to fight and occupy a tremendous amount of time generally set aside for patient care. The emotional cost is priceless. Every year when you fill out your hospital staff membership reapplication and medical malpractice insurance application and every society membership and insurance company provider application and have to list and then re summarize the ongoing or completed action It is painful even if you have completed the process and have prevailed and won the case.

    • rbthe4th2

      Does the physician pay out of pocket, do they take the hit in their wallet on their personal car, home, etc.? No they don’t. It was pointed out on another blog that the skin in the game might be worry, but considering the overwhelming majority of cases are decided for the doctor, I see more cases (like myself) of having to bear the physical and emotional brunt of a doctors’ mistake on my own.

      • Steven Reznick

        I am sorry for your pain and suffering . Yes if the doctor is uninsured or if the judgment is for greater than their insurance coverage they risk their personal assets including their homes and savings.

        • rbthe4th2

          I appreciate that. Many of the doctors I see online are that way. Makes me want to be their patient since I know they have a heart. Plus most tend to have some common sense.

          What I’m looking at is how many are that way, get in that situation? I am sure you are going to find a ton more patients who’ve carried the costs compared to physicians personal money. Hospitals, even the “not for profits” ones, have tens of millions of dollars, even in this area.

          I’m trying to find the link but I saw someone posted the same question, asking on stats for doctors who lost their homes, etc. due to judgements, compared to those who pay the price in terms of bankruptcy alone for medical issues.

          • Steven Reznick

            I do not know the answer to your question. I do know that most physcians in my area have had to go to the expense of obtaining legal assistance in asset protection to protect our homes and families from medical malpractice situations. Bankruptcy may not seem like much compared to the pain you have gone through but quite frankly it is a very tough price to pay If that is the recommendation made by legal counsel to make your personal assets judgment proof

          • rbthe4th2

            I apologize for not being more clear to that. I was saying that we have patients who have declared bankruptcy due to medical errors and they suffer from that. I am saying that the doctors I know in this area are covered by well heeled lawyers and deep pocketed (I think the last figures I saw were over $80M for one group alone) hospitals. The lawyers btw have a reputation for doing anything, dragging things out, etc to wear out the money and time of the person doing the complaining. One group, who had a doctor lose his license for “fraternizing” (shall we say), the patients didn’t sue the hospital or doctor they just complained to the state board, dropped all care for these people and they’re all in rural areas. They only have ER stablizing care.


          • Steven Reznick

            It is difficult to discipline, suspend or revoke the license of a truly unprofessional physician because the due process procedures written into the laws to protect wrongly accused physicians can be used by the physician’s attorney to delay and postpone actions for years at a time. In many cases, by the time the state board of medicine brings the case to a head, the physician involved has closed up shop and moved to another state to practice where the rules and regs are less stringent. I believe this is one of the reasons the National Practitioner Data Bank has been created.
            I have felt for some time now that the med mal situation needs to be handled like an airplane or railroad crash. There should be standardized awards for loss and for medical expenses handled by a workmens compensation type panel. The investigation should be independently structured to not delay compensation to the injured party. The investigation can look for the root cause of the poor outcome and decide to re educate a physician or institution, require supervision while practicing , fine, suspend or remove a practitioner or institution. Take it out of the courts and address the real causes while compensating the injured party quickly.

          • rbthe4th2

            Very understandable. That doesn’t do anything for now though.