9% fewer patients. 5% higher cost per patient.
Emergency physicians after a malpractice allegation see 9% fewer patients at 5% higher cost per patient compared with their own pre-claim baseline. The effect persisted and was the same when the claim was dropped. National Bureau of Economic Research working paper 28330 (Carroll, Cutler, Jena).
A surgeon cannot afford to have shaky hands; a physician, to make a faulty diagnosis. A lawsuit does both, for years, to people who have never had either.
What is actually happening to you
In the study that first named medical malpractice stress syndrome, 86% of sued physicians reported anger and 79% depressed mood, nearly double the rates among physicians who had never been sued (Charles, American Journal of Psychiatry, 1985).
The symptoms have been described in the medical literature since the 1980s: intrusive thoughts about the case, irritability, sleep disruption, shame, withdrawal from colleagues, loss of confidence in clinical judgment, and in a meaningful minority of physicians, depression or new physical illness.
Surveys consistently find that most sued physicians report at least some of these, and that the symptoms track the case rather than the merits. Physicians who are eventually dismissed from suits describe the same distress as physicians who lose.
The clinical word for the overall pattern is litigation stress. The word we use at the Institute is legal trauma, because it is the more accurate diagnosis, and it calls for a particular approach. For a person whose identity is built on competence and care, being formally and relentlessly accused of harming someone is not an inconvenience. It is a core injury, and a betrayal.
What we provide is the right diagnosis and systematic treatment, in the right order, over time.
What you can control is your state of mind, and how the trauma of litigation affects your patients, your revenue and your relationships. This is a specialty. Our program is not designed merely to get you through the trauma. It is designed to channel its potency into excellence and higher performance.
This week
Protect your next clinical shift. If you can trade a shift in the first 48 hours, do so. If you cannot, deliberately slow down: read orders twice, say things out loud, and tell one trusted colleague to double-check you. Defensive, distracted medicine is a known consequence of being sued.
If you are also facing a board complaint, a hospital peer review, or a National Practitioner Data Bank report: those run on different clocks and have different rules. Tell your attorney about every parallel process on day one, and do not respond to any of them without counsel.
What is trainable
1. Deposition anxiety
- Prepare your physiology and your mentality for your deposition.
- Anger management, tone, pace.
A calm, slow, brief witness is worth more to your defense than any amount of chart review.
2. Where to get help that does not create a record
Most support creates discoverable conversations. And formal mental-health treatment, while often the right call, is something many physicians avoid because of licensing-board questions. The way through is structured help that is explicitly not therapy and explicitly not about the facts of the case:
- Your carrier's defendant-support program. Several carriers now offer peer support, litigation education and coaching at no charge to insureds. Ask your claims professional what exists. If nothing does, tell them that other carriers fund it, and send them to our organizations page.
- Confidential coaching that avoids case facts. This is what the Legal Trauma Institute does. The Legal Trauma Recovery Method™ trains your physiology to hold the case without fraying, in twelve weeks of audio practice, a one-day retreat and small circles. Nothing is recorded, nothing is charted, and you will never be asked what happened.
- Your state physician health program, for anyone whose sleep, drinking or mood has become a safety issue. Most are confidential and most are helpful.
The suit will take the time it takes. With the Legal Trauma Recovery Method™ we protect your time and attention while it grinds on. It does not get to take you.