medical malpractice: how to cope - allen - hscp 2018... · coping with a medical malpractice suit....

MEDICAL MALPRACTICE: HOW TO COPE

Timothy Craig Allen, MD, JD

The University of Mississippi Medical School

The University of Mississippi Medical Center

Disclosures

■ Nothing herein should be considered legal advice

■ Nothing herein necessarily represents the opinions of the University of Mississippi Medical School or the College of American Pathologists

Goals to help pathologists cope

■ Understand the basics of medical malpractice law and discuss specific legal criteria that determine medical liability

■ Understand the typical timeline of a medical malpractice lawsuit

■ Learn how to ethically negotiate a deposition and avoid its pitfalls

■ Consider ways to minimize the emotional and psychological impact of a medical malpractice lawsuit on the pathologist and the pathologist's family

“…ideally…”

■ “…ideally, [a physician’s post-medical malpractice lawsuit] adaptations lead to greater competence and a more satisfying personal and professional life”

– Charles SC. Coping with a medical malpractice suit. West J Med 2001 Jan; 174(1): 55-58.

■ “…being sued for medical negligence is a predictable hazard of medical practice in our times. Education of the sued physician about medical malpractice stress is the key to dealing with the fear of litigation.”

– Sanbar SS, Firestone MH. Medical malpractice stress syndrome. https://www.acep.org/uploadedFiles/ACEP/Professional_Development/Faculty_Development/Medical%20Malpractice%20Stress%20Syndrome%20article%20for%20web.pdf

How well do we understand?

Allen TC, Stafford M, Liang BA. Pathology and medical malpractice. Academic and trainee

empirical review of cases by State of Texas physicians. Am J Clin Pathol. 2014

Apr;141(4):501-9

Do we practice defensively? B=PL

Allen TC, Liang BA. Pathologists and liability: an old medical story needing a new ending.

Am J Clin Pathol. 2015 Dec;144(6):828-9

First, some facts…

■ Levy S, Kane L. Medscape Malpractice Report 2017. Medscape Pathology and Laboratory Medicine. https://www.medscape.com/slideshow/2017-malpractice-report-6009206, accessed 11/21/17




■ Learn how to negotiate a deposition and avoid its pitfalls


The Basics of Medical Malpractice

■ The tort of negligence

■ “Conduct which falls below the standard established by law for the protection of others against unreasonable risk of harm”

■ Four elements of a negligence lawsuit:

– An actor owes a DUTY of care to another

– There is a BREACH of the applicable standard of care for carrying out the duty

– As a PROXIMATE CAUSE of the breach of duty an injury results

– Compensable DAMAGES or injury to the plaintiff occurs

If hay is stacked from moist grass, bacterial fermentation may cause high temperatures where a chemical reaction produces flammable gas Farmers must be careful to avoid this "spontaneous combustion”

“Keeping hay fires from spontaneously combusting.” Montana State University Communication Services

http://users.tkk.fi/jsreunan/Romania_pics/slides/cascada_cailor.html

Vaughan v. Menlove

■ Vaughan v. Menlove, 132 Eng. Rep. 490 (C.P.) 1837

■ Defendant built a haystack near the plaintiff’s land

■ Defendant, warned over 5 weeks that the haystack was poorly-built and might catch fire, said he “would chance it”

■ It caught fire and destroyed the plaintiff’s barn and two rental cottages

“Reasonable Person” standard of care

■ Vaughan introduced the “Reasonable Person” standard of care

■ The court held that the defendant’s standard of care was determined by whether the defendant “proceed[ed] with such reasonable caution as a prudent man would have exercised under such circumstances”

■ The “reasonable person standard of care” has become an important part of negligence law, including medical malpractice law

Legal experts on standard of care

■ “Ordinary”

■ “Average”

■ “Customary”

■ “Normally-possessed”

■ “Reasonably competent”

■ “Minimally competent”

■ “Interpreted just a little bit differently by everybody”

The expert witness’ job

■ An expert witness must:

■ Define a standard of care

■ Opine as to whether it has been breached

■ Opine as to whether any perceived injury was caused by the breach

“Battle of the experts”

■ “Ordinarily, to carry this burden the plaintiff must find a medical expert who is qualified and willing to testify that the standard of care was violated. Typically, defendants, too, must find their own expert to testify that the standard of care was not violated.”

■ Case studies of settlement failure. In: Vidmar N. Medical Malpractice and the American Jury: Confronting the Myths about Jury Incompetence, Deep Pockets, and Outrageous Damage Awards. University of Michigan Press: Ann Arbor;1995, 59.

The court’s charge

■ The Court’s goal is to try the case to conclusion in a procedurally correct manner

■ The Court also is under pressure to control its docket

■ “[I]t is not the primary goal of the tort system to achieve a scientifically correct conclusion.”

■ Wick MR, Foucar E. Evidence-based medicine and tort law. SeminDiagn Pathol 2005;22:167-176.

Loss of chance doctrine

■ An alternative medical malpractice legal theory of liability

“But for” causation

■ In traditional medical malpractice cases, the “but for” causation standard sets a clear rule for determining whether the physician’s alleged action was the cause-in-fact for the plaintiff’s injury

■ Liability occurs where the physician’s action is considered “more likely than not”(51% probability) to have caused the plaintiff’s injury

■ (In comparison, the “beyond a reasonable doubt” standard, the exclusive standard used in criminal cases, has been considered to be 99%)

■ When the physician’s action satisfies the “but for” test, and is sufficiently direct (proximate), then the action is considered the legal cause for the plaintiff’s injury

■ If the physician’s action is found to have a less than 50% probability of having injured the plaintiff, the case fails and the plaintiff “takes nothing”

Relaxed standard of causation

■ The doctrine relaxes the causation standard of traditional negligence law

■ Under the loss of chance doctrine, the plaintiff would be compensated for an injury found to be negligently caused by a physician for the extent to which the physician’s negligence reduced the plaintiff’s chance of survival or having a better outcome, if less than 51%

■ But if greater than 51%, the physician’s extent of negligence is not considered, and the plaintiff received full (100%) recovery

Ambiguous causation

■ It is being used more and more in cases where it is difficult to show that a physician was “more likely than not” negligent under the traditional “but for” causation standard

■ These cases often involve elderly and very ill patients, for whom there are alternative preexisting conditions, giving rise to “ambiguous causation”, e.g., in a case involving a patient death, whether the patient died from the physician’s negligence or an alternative preexisting condition

Smith v. Providence H&S-Oregon, et al.

■ 361 Ore. 456; 2017

■ P goes to ER with headache, visual disturbances; CT shows no bleeding, MRI suggested if symptoms persist

■ P returns to ER with persistent symptoms; D sends P to family MD, with order for MRI, but not expedited order

■ MRI at end of week shows substantial brain damage from stroke

■ Testimony claims failure to order expedited MRI resulted in loss of chance for treatment which 33% of time reduces or eliminates stroke symptoms

Smith v. Providence H&S-Oregon, et al.

■ Court determines Oregon adopts the loss of chance theory

■ “…the defendant’s tortious conduct was the reason it was not feasible to determine whether or not the more favorable outcome would have materialized but for the tortious conduct.”

– Smith v. Providence, citing King JH. “Reduction of Likelihood” reformulation and Other Retrofitting of the Loss-of-a-Chance Doctrine, 28 U Mem L Rev 492 (1997)

Knox et al. v. Rana et al.

■ 2016 Tex. App. LEXIS 12381

■ P “had survived breast cancer and endometrial cancer.” Now receiving radiation treatment for basal cell carcinoma on the nose

■ D ordered PET scan based on prior history of cancers; PET report showed pelvic mass “suspicious for metastatic disease.”

■ P says never told, and so did not undergo a followup PET scan as ordered; she was later diagnosed with metastatic cancer and died; testimony showed failure to get PET scan made no difference in P’s outcome

■ Court states recovery is barred “if a condition preexists the negligence of a health care provider and at the time of the negligence, the condition resulted in the patient having a 50% or less chance of cure or survival.”

Why now?

■ “When treatment options are primarily only supportive or nonspecific, regardless of when a diagnosis is made, and as such early diagnosis does not improve overall survival, showing that misdiagnosis or a delay in diagnosis was the injury’s ‘‘proximate cause’’ could be extremely difficult, or perhaps impossible. The loss of chance doctrine provides the plaintiff no increased benefit beyond the typical medical malpractice negligence doctrine in those situations; the plaintiff probably could not prove ‘‘proximate cause’’ by either method.”

■ “With the development of new diagnostic and therapeutic regimens; however, many diseases, including cancers, that were once merely treated supportively now have available, or may soon have available, specific therapies, including molecular-based therapies, which, if diagnosed early, provide the patient an improved prognosis. In these cases, the loss of chance doctrine may provide plaintiffs who could not prove that misdiagnosis or a delay in diagnosis was more likely than not the proximate cause of the plaintiff’s injury an avenue through which they might prevail.”

■ Allen TC. Loss of chance doctrine: An emerging theory of medical malpractice liability. Pathology Case Reviews 2012;17: 172-174.

21st century applications

■ Molecular testing of cancer

■ Recent and relatively sudden shift to specific, detailed, molecular-driven diagnoses that must be done quickly and accurately to guide the use of extremely expensive therapy that has the potential to significantly extend the life span of cancer patients, e.g., TKIs and late-stage lung cancer patients

Real world scenario

■ Multigene predictors of cancer therapy for which evidence-based literature is still developing

■ Utilize a new molecular test and recommend a course of action, or do not utilize it and recommend another course of action:

■ “In either case, with the advantage of perfect hindsight, the physician could be portrayed by a skilled trial lawyer as having acted too slowly or too quickly to rely on multigene predictor assays.”

■ Issa AM, Chaudhari VS, Marchant GE. The value of multigene predictors of clinical outcome in breast cancer: an analysis of the evidence. Expert Rev MolDiagn. 2015 Feb; 15(2):277-286.

The doctrine is appealing

■ “…human life is precious and…even the loss of only a small chance of cure or survival is a significant loss.”

■ “…acts of negligence…to patients with poor prognoses should not go unredressed…”

■ “…fundamentally unfair to permit recovery where the negligence had a 51 percent possibility of producing the harm complained of but denying any recovery where the proof is only a 50 percent possibility.”

■ Weigand TA. Loss of Chance in Medical Malpractice: The Need for Caution. Massachusetts Law Review. http://www.massbar.org/publications/massachusetts-law-review/2002/v87-n1/loss-of-chance-in-medical

But

■ “…the practice of medicine is not an exact science and in most instances there is more than one acceptable approach…”

■ “Health care providers could find themselves defending cases simply because another course of action could possibly bring a better result.”

■ “To impose liability on physicians based on loss of chance is to impose a burden that no other professional malpractice defendant carries.”

■ May encourage “a proliferation of defensive medicine, an escalation of medical costs, and an unwarranted expansion of liability exposure…”

■ Weigand TA. Loss of Chance in Medical Malpractice: The Need for Caution. Massachusetts Law Review. http://www.massbar.org/publications/massachusetts-law-review/2002/v87-n1/loss-of-chance-in-medical

Perfect storm

■ Increasing understanding of disease processes, specifically molecular pathology

■ Corresponding increase in therapies for these diseases, often requiring early diagnosis and fast treatment in order to provide successful results

■ Increasingly expectant society with less appetite for medical failure

■ Increasingly cost-conscious medical administrators, with resultant increased work loads and increased chance of error

■ Aggressive medical malpractice attorneys exploring options to advance cases in light of tort reform

■ Courts becoming more comfortable with using the loss of chance doctrine

Attorneys are aware

Medical Malpractice Lawsuit Timeline

■ Presuit notice

■ Lawsuit events

■ Trial

Presuit notice

■ No attorney is yet involved

■ Critical to act promptly

– Correct conduct maximizes legal protections

– Avoid conduct that is potentially harmful to the pathologist’s case

■ Notice letter

■ Patient’s chart

■ Discussion of the claim

Insurer responsibilities

■ Defend the pathologist in the lawsuit

– Retain an attorney for the pathologist

– Defend the pathologist during the entirety of the proceeding

■ Indemnify the pathologist

– Pay a settlement up to the policy limits

– Pay a judgment on any covered claim

– Policy may have a “consent clause” requiring pathologist’s consent to settle the claim

Pathologist’s responsibilities

■ Notify the insurer promptly if any potential claims

– Failure to do so may jeopardize the insurer’s obligations to the pathologist in the lawsuit

■ Cooperate with the defense attorney during the duration of the claim and subsequent lawsuit

– Trust the attorney, be completely candid, and follow the attorney’s advice

Notice letter

■ From Plaintiff’s attorney

■ Advises pathologist of Plaintiff’s intent to sue

■ Puts pathologist on notice of potential claim

■ Not a lawsuit

■ Not filed with the court

■ State law specific

■ Required by state to encourage presuit negotiations and settlement

Notice letter

■ Notify the insurer immediately upon receipt

■ Provide insurer any additional documentation

■ Delay in notification can jeopardize coverage

■ Notify insurer of any notice or service suggestive of or resembling a legal claim

– Discovery request

– Deposition notice

■ If contacted by an attorney, do not discuss the case and immediately inform the insurer

Patient’s chart

■ Not as much a concern with electronic medical record

■ For pathologists, major concern is spoliation of evidence

■ Place slides and blocks in safekeeping, as instructed by insurer

■ Do not do additional sections or stains, as such could be argued to be spoliation

Discussion of the claim

■ Discuss the claim only with the insurer and the attorney provided by the insurer

■ Avoid the temptation to discuss the claim with colleagues

■ Those discussions are at high risk for being identified and recounted during discovery

Lawsuit events

■ Formal beginning of the lawsuit

■ Statute of limitations

■ Discovery

■ Pretrial means of disposition

■ Mediation

Formal beginning of the lawsuit

■ Plaintiff’s attorney files a petition with the court

■ There is then service of the petition and citation on the pathologist

■ The pathologist is now a defendant in the lawsuit

■ Immediately call the insurer, then forward copies of the petition and citation

Formal beginning of the lawsuit

■ It is typically at this point that the insurer assigns an attorney to the pathologist

■ The pathologist must immediately notify the insurer for timely filing of the lawsuit answer

■ If answer is not filed by the court’s deadline, Plaintiff may obtain a default judgement against the pathologist, and proceed to execute on the pathologist’s assets for the amount of the default judgment

Statute of limitations

■ State specific

■ Not uncommonly medical malpractice claims have a two year statute of limitations

■ Notice letter may extend it

■ Discovery rule

– Tolls the statute of limitations where Plaintiff is unable to discover the event that is the basis for the legal claim; otherwise prevents bringing of lawsuit before its basis is discoverable

Discovery

■ Filing of the lawsuit initiates the discovery phase

■ Discovery is broad and includes all documents and information likely to lead to the discovery of admissible evidence, whether or not that information or those documents are ultimately themselves admissible

■ Pathologist often invests significant time and effort into responding to discovery

Forms of discovery

■ Interrogatories: written questions served by the parties

■ Requests for disclosure: state specific requests for basic lawsuit information such as experts, damages, contentions

■ Requests for production: requests for written documents

Forms of discovery

■ Requests for admissions: time sensitive requests to admit or deny contentions or facts

■ Expert reports: contain the party’s experts’ opinions and bases for those opinions

■ Depositions: sworn testimony by witnesses

Pretrial means of disposition

■ Motion for summary judgement: Dispositive motion; a judgment on the merits, usually filed asserting defenses such as statue of limitations or Plaintiff’s inability to produce a qualified expert capable of establishing negligence

■ Motion to dismiss: Dispositive motion; usually filed when Plaintiff fails to produce an expert CV and expert report establishing negligence

Pretrial means of disposition

■ Settlement: Agreement by parties; often pathologist does not admit negligence but settles to avoid time and harassment of defending the lawsuit. The parties execute and file with the court an agreed motion for nonsuit; judge executes the order

■ Voluntary nonsuit: Rare; Plaintiff drops claim, often strategically, in order to refile with a narrower group of defendants

Mediation

■ Nonbinding

■ Usually requires a half day or day, with all parties and attorneys present

■ Insurer must be present or available to authorize settlement

■ Uses an independent third party mediator

■ Mediator attempts to persuade parties to resolve the case

Trial

■ Most medical malpractice lawsuits settle before trial; some settle during trial

■ Several years from lawsuit filing to the trial

■ Trial date is often uncertain until very close to the beginning of trial

■ Pathologist usually must dedicate two weeks for the trial, be prepared to testify, and sit with the attorney at the counsel table during the trial

The fact witness deposition

■ Testimony of a witness under oath before a court reporter

■ Treated as courtroom testimony

■ Conducted in accordance with state or federal court rules

■ A discovery device

■ One party asks oral questions of the other party or its witness

■ May be performed in a formal or an informal manner

■ Locations—attorney’s office, doctor’s office, hotel room, or court reporter’s office

Deposition

■ Deponent

■ Attorneys for parties

■ Court reporter

■ Videographer in some cases

■ Transcript is written

■ Word by word account of all that is said in the deposition

■ May be audiotaped and/or videotaped

■ Witness is entitled to a copy to clarify an answer or correct spelling

■ Do not waive the right

Plaintiff’s attorney’s goals

■ Educate herself about the subject

■ Learn what facts the defendant knows

■ Learn the defendant’s strategies

■ Judge the effectiveness of the defendant at trail

■ Impeach the defendant’s credibility


■ Learn the defendant’s strategies

■ Do not volunteer information

■ Answer “yes” or “no” or in short sentences

■ Beware of compound questions

■ Do not agree to supply any documentation or other information to the plaintiffs’ attorney


■ Judge the effectiveness of the defendant at trial

■ Dress professionally

■ Be calm, professional, polite, knowledgeable

■ Do not appear arrogant (explain medical terms)

■ Keep emotions in check; do not joke


■ Impeach the defendant’s credibility

■ If unsure, state, “I don’t know” or “I don’t remember.”

■ Pause before answering to consider the question, and to give your attorney an opportunity to object

■ Clarify any mistake

Plaintiff’s attorneys

■ Pal

■ Freight train

■ Butterfly

■ Time bomb

■ Ignoramus

– Surv Ophthalmol 1995;40:69-72.

– Am J Surg Pathol. 2001;25(4):527-537.

Pal

■ Joking and banter before the deposition

■ Informal setting

■ Casual dress

■ Recognize the tactic and ignore

Freight train

■ Questions the deponent in a rapid-fire manner, prompting the deponent to answer before thinking

■ Answer after a moment, slowly, in complete sentences, to break the rhythm

Butterfly

■ Moves from one line of questioning to another

■ Confusing, attempting to elicit conflicting statements

■ Ignore and answer consistently

Time bomb

■ Most difficult, complicated, or contentious questions are presented at the end of the deposition

■ Hope that fatigue will cause inconsistencies or wrong answers

■ Ask for a break

Ignoramus

■ Appears ignorant in an attempt to get deponent to volunteer information

■ May leave time after an answer to prompt deponent to volunteer more

■ May use body language to prompt deponent to volunteer information

■ Recognize the tactic and resist volunteering information

Common misconceptions

■ It is not a forum to defend yourself

■ It is not a forum to tell your story (your defense attorney is not going to elicit your story then, and the plaintiffs’ attorney is only interested in facts that help her client

■ It is not a forum to prove you are a smart doctor

Remember

■ Remember that a deposition is an adversarial proceeding

■ Never consider a deposition as “routine”

■ Listen to the entire question

■ Make certain you understand the question

■ Ask that a question be repeated if necessary

Remember

■ Do not attempt to rephrase a question

■ Do not accept a summary of facts without considering the accuracy of those facts

■ Beware of misstated facts or prior testimony attempting to elicit information

■ Look through medical records or other materials at hand

■ Do not take anything with you to the deposition

Remember

■ Do not allow yourself to be rushed into answering

■ Do not volunteer information or speculate

■ Avoid absolutes such as “always” and “never”

■ Avoid saying “honestly” or “to be honest”, from which it may be implied that prior answers were not honest ones

■ Do not verbally spar with the questioning attorney—you will always lose

Deposition

■ “The other side would love to hear all of their thinking…because they will give that to their experts to tear apart and come up with 30 other reasons why [that explanation] wasn’t right.”

■ “And the fun part of the deposition is that there isn’t going to be a judge there to rein you in so you can ask them anything you want.”

■ “Some deponents have even been asked to empty their pockets at a deposition.”

■ “Also, the plaintiff’s attorney can be so punishing in their questioning that the witness would rather settle than face a repetition of the experience at trial. These tactics are considered ethical….”

■ “Everything in the deposition is teased out, taken out of context, used against you.”

■ Uraneck K, Proper preparation is the key to a successful deposition, American College of Emergency Physicians News, October 2002.

High stress event

■ “Becoming involved in a lawsuit can be a significant event for anyone, including a physician. It can require a great deal of the physician's time and effort, can be emotionally draining, and can serve a psychological blow to the physician's professional psyche.”

– Berry DB. The physician's guide to medical malpractice. Proc (Bayl Univ Med Cent). 2001 Jan; 14(1): 109–112.

“… a source of much fear…”

“The lawsuit arrives like a modern day version of the ‘Black

Spot’…”Sacopulos MJ. Physicians aren’t alone: understanding and dealing with malpractice litigation stress.

http://www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/11117-physicians-arent-

alone-understanding--dealing-with-malpractice-litigation-stress

“In the book, pirates are presented with a ‘black spot’ to officially pronounce a

verdict of guilt or judgement. It consists of a circular piece of paper or card, with

one side blackened while the other side bears a message and placed in the hand

of the accused. It was a source of much fear because it meant the pirate was to

be deposed as leader, by force if necessary—or else killed outright.”

Black spot (Treasure Island), Wikipedia.

https://en.wikipedia.org/wiki/Black_Spot_(Treasure_Islan

d)

http://www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/11117-physicians-arent-alone-understanding--dealing-with-malpractice-litigation-stress

How serious is a medical malpractice lawsuit to a physician?

Allen TC. Medicolegal issues in pathology. Arch Pathol Lab Med. 2008 Feb;132(2):186-91

“…not a vocation…”

■ “For many physicians this is not a vocation, this is their life and being sued in an invasion of their life.”

– Sacopulos MJ. Physicians aren’t alone: understanding and dealing with malpractice litigation stress. http://www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/11117-physicians-arent-alone-understanding--dealing-with-malpractice-litigation-stress

■ “…[T]he grinding, drawn-out repercussions of a prolonged lawsuit frequently require…extensive support, including professional mental health resources.”

– Coping with the stress of medical professional liability litigation. Committee on Professional Liability, ACOG. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Professional-Liability/Coping-With-the-Stress-of-Medical-Professional-Liability-Litigation


https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Professional-Liability/Coping-With-the-Stress-of-Medical-Professional-Liability-Litigation

“…devastating.”

■ “…physicians are acutely sensitive to any suggestion that they have failed to meet the standard of care or are not ‘good’ doctors. Their honor—that sense of personal integrity that most people cherish—is at issue, and the threat of its loss is devastating.”


Just how devastating?

■ Major depressive disorder:

up to 39%

■ Adjustment disorder:

up to 53%

■ Onset or exacerbation of physical illness:

up to 15%

■ Acknowledge alcohol or drug misuse:

less than 2%

How to cope

■ “A feeling of being out of control pervades the litigation process…regaining mastery is central.”

■ “…the more rapidly this is achieved, the better because chronic stress can lead to further disability.”


Knowledge is power

■ “…an adequate knowledge base about what can be anticipated psychologically and about the process in which the physician is now a participant…”


Social support is critical

■ “…physicians need to share their feelings and reactions with someone who is trustworthy, understanding, and sensitive to their concerns…”

■ “Legal counsel will advise not to talk about the details of the case to anyone.”

■ “It is not…good psychological advice.”


Social support is critical

■ Discuss with your attorney early in the process

■ Know the limitations of what can—and importantly what cannot—be discussed with partner, colleagues, support group, or counselor

Regain control and self-esteem

■ Use your social support as fully as possible

■ Take care of yourself

– Exercise; spend time with a hobby

– Take that much-needed vacation

■ Understand your litigation process

– Get to know your attorney

– Learn the anticipated timeline

– Learn your role in each step of the process

– Schedule enough time off for the trial

Helpful words of advice

■ Change the meaning of the event

– You are not a “bad doctor” or “incompetent”; change that narrative

– Be objective; acknowledge the “truth” about the event in question

■ “…think of the lawsuit as a reflection of our times, more than your competence as a physician.”

■ “…doesn’t necessarily reflect your competence. Most ethical and compassionate physicians are sued. This is because they won’t shy away from caring for the most medically complex patients, or the most emotionally troubled patients.”

■ Sued physicians are often the best in their field, taking care of the most high-risk patients; and most are vindicated in the end

– Sacopulos MJ. Physicians aren’t alone: understanding and dealing with malpractice litigation stress. http://www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/11117-physicians-arent-alone-understanding--dealing-with-malpractice-litigation-stress ; adapted from Wang DC. The Kitchen Shrink: A Psychiatrist’s Reflections on Healing in a Changing World.


Helpful words of advice

■ “Many lawsuits are simply frivolous. [You might be] sued for simply being in the room.”

■ “…focus on what’s in your control—such as continuing to practice, and doing your best for patients. Obsessing about things not in your control causes anxiety.”

■ “…the lawsuit will pass.”

■ “…focus on why you got into medicine in the first place. All the human improvement and relief you provide should not be marred by some litigious miscreants.”

– Sacopulos MJ. Physicians aren’t alone: understanding and dealing with malpractice litigation stress. http://www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/11117-physicians-arent-alone-understanding--dealing-with-malpractice-litigation-stress ; adapted from Wang DC. The Kitchen Shrink: A Psychiatrist’s Reflections on Healing in a Changing World.


Thank you!

medical malpractice: how to cope - allen - hscp 2018... · coping with a medical malpractice suit....

Documents