SGO Wellness: “You’ve Been Served”: Three Words Every Physician Dreads | Nisha Bansal, MD

Nisha Bansal, MD

As gynecologic oncologists, we are no stranger to “bad” outcomes. Whether these undesired outcomes are the result of a disease taking a premature course, or that of complications endured during a difficult procedure, the impact of these events is a common stressor in our profession. As much as we are trained to face these untoward events with understanding and compassion for our patients, their families, and even our trainees, we oftentimes forget to have compassion for ourselves when navigating these experiences. Add to this burden being served with a lawsuit, and the resulting emotional toll can sometimes be too great to bear.  How are we to cope with this added stress on top of an already demanding profession?

Obstetrics and Gynecology (OB/GYN) remains one of the most frequently sued specialties, with nearly 79% of OB/GYN physicians reporting being sued at least once in their career [1]. Physicians facing medical malpractice litigation may experience a wide range of distressing emotions which can affect both personal and professional relationships, including relationships with their families, patients and coworkers [2]. Physicians often experience feelings of shock, guilt, shame, anger, and self-doubt [2]. These feelings can further develop into physical ailments such as stress, anxiety and depression [2]. The first piece of legal advice bestowed upon us is, “do not discuss this case with anyone,” which adds to the isolation we face.  We feel attacked not only on a professional level, but on a deeply personal one as well.

With so many of us having faced medical malpractice litigation at least once in our careers, how can we help one another deal with the emotional fallout? Many physicians are reluctant to share their own experiences with medical malpractice litigation as they feel it reflects poorly on them. In fact, it wasn’t until my research for this piece, long after my litigation was over, that I realized I had experienced each of the above reported symptoms. I remember the shock I felt when being served with papers, and the anger when reading the inflammatory language of the complaint. I felt betrayed by my patient whom I had worked so hard to help, and by a system that allowed such a perceived injustice. When these feelings turned to fear and anxiety, I felt isolated. While we cannot discuss the details of a case, we can discuss the emotions we face as a result of a lawsuit with family, or other trusted confidantes. We can also turn to a mentor for support in navigating the legal process. Finding a colleague who is willing to share their experiences and offer advice can be of immense benefit. As physicians, we often bear the burden of poor outcomes alone, but simply talking to one another can be a huge relief.

The tools we use as gynecologic oncologists to deal with the difficult occurrences in our profession, such as informing patients of a cancer diagnosis or a surgical complication, are the same tools we can use to cope with the stress of medical malpractice litigation. While we have little control over the legal process, we can control how we react to this process. We can stay healthy and calm through exercise, personal interests, and quality time with loved ones. We can also prepare ourselves by being an active member of our own defense, by partnering with our attorney and painstakingly reviewing the medical record. Finally, we must remember there is always resolution of these cases and life beyond malpractice litigation. We will come out on the other side with possibly some lessons learned but definitely with a continued devotion to providing excellent, compassionate care to our patients as we have not only been trained but destined to do.

References:

1. Medscape Ob/Gyn Malpractice Report 2021. https://www.medscape.com/slideshow/2021-malpractice-report-obgyn-6014792
2. Coping With the Stress of Medical Professional Liability Litigation. ACOG Committee Opinion Number 551. January 2013.

Additional Resources:

Physician Litigation Stress Resource Center. Available at: http://www.physicianlitigationstress.org.

Nisha Bansal, MD, is a gynecologic oncologist at New York City Health and Hospitals/Jacobi Medical Center and an Assistant Professor in Gynecologic Oncology at the Albert Einstein College of Medicine in New York, NY.