You have just signed out from one of the best shifts in your career. You feel like you were born to do this! You’re a great EM doctor! Then, you spot him, a man in a dark suit making eye contact as you walk through the lobby towards the exit. He stops and asks, “Are you Dr. About-to-get Sued?” Being named in a malpractice lawsuit is a potentially devastating, frequently unmentioned, and yet rather common event in EM. Providers may find themselves feeling isolated and ashamed, questioning their career choice regardless of the trial outcome. Members of the ALiEM Wellness Think Tank recently spoke with Dr. Gita Pensa about how to find resilience in EM despite involvement in a lawsuit. We provide the full podcast and a summary below.
Prevention is Paramount
Each patient encounter carries a certain amount of risk. Documentation in the ED chart should be thoughtful and complete. Frequently, it will be the only trigger for your memory to help you recall the encounter. Build rapport with patients and their family. As much as possible, involve both the patient and family in the plan of care and be sure to document shared decision making.
What about after you get served? Find a confidant, someone who has gone through the process and can help you navigate your experience. A fellow physician who has been sued understands the stress, the process, and the sacrifices you’ve made to get to where you are in your career. If you don’t have a mentor who has been through the process, reach out on a physician group platform.
Check with your employer for available resources, including peer-to-peer programs at your hospital. Though it is not recommended that you talk about the details of the case, you can talk about the stress and emotional effects that it is having on you. Take some time for introspection, acknowledge your emotions, and find support.
There are many ways you can learn about the litigation process. Both ACEP and AAEM have information pertaining to medical malpractice and other legal issues.
Your attorney will also serve as a critical resource. He or she will inform you of your responsibilities and prepare you for deposition and testimony as needed. Dr. Pensa recommends getting your own counsel, distinct from the hospital. In-house counsel has a fiduciary responsibility to the hospital. You need someone on your side who will consider your perspective, integrity, and future as a physician.
Other informative resources include:
- When Good Doctors Get Sued by Angela M. Dodge
- How to Survive a Medical Malpractice Lawsuit: The Physician’s Roadmap for Success by Ilene R. Brenner
- Adverse Events, Stress, and Litigation: A Physician’s Guide by Paul R. Frisch and Sara C. Charles
- MD Mentor: Personalized Litigation Stress Support for Health Professionals from Dr. Louise Andrew
During litigation and after the process is over, you may find yourself distrusting patients, or fearful in general of returning to patient care. Acknowledge your emotions and make a conscious effort to “look for the good” in each patient encounter. Remind yourself of your purpose in the ED: “I care. I am here to help.”
Dr. Pensa reminds us that we will be okay. Most EM physicians go through litigation at some point in their career and it is rarely career-ending. We can harness the support we have around us to build resilience and cope with the distress of litigation. It is unfortunate how shame and mystery often accompany involvement in a malpractice case. There is a need for support amongst our EM colleagues, and the first step is to normalize the conversation around the topic. A case may take several years to resolve, so we should support our colleagues and get through it together.
More from the Wellness Think Tank
Join us for the ALiEM + Essentials of EM Resilience Training for Residents! This exclusive, interactive workshop will help you obtain some of the psychological skills needed for personal and professional resiliency.
Location: Essentials of EM Conference in Las Vegas
Date: May 14, 11:00 AM to 3:00 PM
Cost: $249 (includes entry to the entire conference)
Even if you can only attend the Resilience Training, you will be granted access to all of the EEM lectures and content online! Sign up through your EMRA membership portal.
Questions? Contact us.
We would like to thank USACS for their exclusive support and sponsorship of the Wellness Think Tank!