Be active, not passive
What you can do. Contact your insurer and risk manager immediately. Inquire about the average length of litigation in your jurisdiction (it might be 1 to 5, or more, years, depending on locality, type of case, and severity of injury). Ask your attorney to describe the steps in the process and your role as the case proceeds.
Take whatever steps are necessary to cover your clinical duties. If your initial emotional reaction is disruptive, obtain coverage or rearrange your schedule. Expect to change or limit your schedule before depositions and during trial to allow adequate time for preparation.
Accept the fact that you must play by rules far different from those of medical care. Litigation is time-consuming and frustrating. Delays and so-called continuances are common in legal proceedings, so expect them. Consider adapting to your situation the strategies that other sued physicians have found useful in regaining control over their life and work (TABLE 5).
TABLE 5
Regain control and manage your practice during litigation
| Learn as much as you can about the legal process |
| Introduce good risk-management strategies, such as efficient record-keeping, into your practice |
| Clarify the responsibilities of office personnel and coverage responsibilities with associates |
| Rearrange office schedules during periods of increased stress |
| Reevaluate your time commitments to work and family |
| Participate in relevant continuing education |
| Make sure your financial and estate planning is current |
| Cooperate with legal counsel |
| Devote sufficient time to deposition preparation and other demands of the case |
| Carefully evaluate the advice of legal and insurance counsel regarding a settlement |
| Don’t try to “fit patients in” while on trial; a trial is a full-time job |
Get needed support
Talking about the case. Sharing, with responsible confidants, your emotional reactions to being sued is healthy for you and others affected. Lawyers, however, may caution you not to “talk to anybody” about the case. They don’t want you to say anything that would suggest liability or jeopardize their defense of the case.
This may be good legal advice, but it is not good psychological advice. The support of others is a natural help during major life events that cause enormous stress and disruption.10 You can resolve this dilemma by accepting the discipline of talking about your feelings regarding the case without discussing the specifics of the case.
In addition to lawyers and claims representatives, you may talk with your spouse or another trusted person or colleague about your feelings. When you choose to talk with a psychiatrist or other mental health professional about your litigation experiences, you are protected by the confidentiality inherent in the doctor–patient relationship.
Trust issues. At the core of all medical work lies trust. As a well-trained and competent professional, you do not expect to be sued by patients with whom you have trusting and often long-term relationships. Most physicians acknowledge that after being sued their relationships with patients change.11,12 You may find it difficult to reestablish trusting and comfortable relationships with other patients, especially those who have conditions similar, often high-risk, to that of the suing patient.
A charge of negligence exposes our vulnerabilities and leaves us feeling hurt and betrayed, feelings that are not easily overcome. As one psychiatrist ruefully observed: “I lost my innocence.”8
Conflicted feelings may emerge. The distress associated with a lawsuit often exacerbates the many outside stressors associated with practice. Many solo practitioners find themselves already overextended, working longer hours, covering more hospitals, and rarely taking vacations. Younger physicians who prize “time off” and lifestyle above other incentives remain stressed by the unpredictable schedules associated with ObGyn practice. Women physicians increasingly constitute a greater percentage of the ObGyn specialty. Although some work part-time or, at least, fewer hours than their male counterparts, they must nonetheless keep current and continually hone their skills.
The stress associated with all of these conditions can increase an ObGyn’s vulnerability to the occurrence of an adverse event and, eventually, to a lawsuit. It is also known that physicians involved in a claim-producing event are twice as likely as their non–claim-producing counterparts to have another such event within the ensuing 12 months.13
When you are sued, you may feel overwhelmed and out of control. Because physicians’ ability to control their schedule and work hours is a known major predictor of their overall health (as evidenced by a balance between their work and personal life),14 regaining control over those aspects of your life that are “controllable” (TABLE 5) is an essential strategy in dealing with a lawsuit.
As a result of your lawsuit, you may contemplate changing practice circumstances or retiring early. Feelings that you must change the way you practice and chronic anxiety about your work are barriers to good practice. Personal therapy may help if you remain uneasy or cannot resolve life choices that overshadow your work with patients.