There is increasing awareness of the negative emotional toll of malpractice litigation on EPs.1-3 “As with many of the system factors that lead to burnout, malpractice risk is increasingly on the radar of providers,” says Martin Huecker, MD, associate professor and research director in the department of emergency medicine at the University of Louisville School of Medicine.

Huecker and colleagues found the longer an EP practices, the more likely it is he or she will become a defendant in a malpractice lawsuit.4 Their work revealed that, overall, EPs carried a 7.5% annual risk of litigation. “In emergency medicine, you are more likely to be named in a lawsuit than not,” Huecker. “[In the ED], we practice in a setting that looks like total chaos, facing uncertainty, diagnostic time constraints, inpatient consultants, and often limited staffing.”

Lack of prior patient relationships, inadequate histories, and presentation late in the disease process all present unique legal risks for EDs. “Lawsuits are very common among emergency physicians because of the nature of our practice,” notes Robert Broida, MD, FACEP, president of Sarasota, FL-based ED Quality Solutions.

EPs who find themselves defendants do have resources — at their hospitals, from their professional liability carriers, from mental health professionals, and from specialty organizations. “Physicians should feel free to access the many support systems that are available to them,” says Broida. Some examples:

  • The American College of Emergency Physicians (ACEP) offers a litigation stress primer.
  • The American Academy of Emergency Medicine encourages members to ask for assistance with a malpractice lawsuit, or if they are victims of unfair or inaccurate expert testimony.
  • The Council of Residency Directors in Emergency Medicine offers a Medicolegal Toolkit.

As a member of ACEP’s Medical-Legal committee, and his work leading two different malpractice carriers offering such services, Broida heard from many EPs who suddenly found themselves defendants. “Many docs have expressed heartfelt thanks once they availed themselves of such support services,” Broida reports.

Talking with other EPs who have been sued can be helpful. “With the high incidents of lawsuits in emergency medicine, it’s almost a certainty that someone else in your group has experienced this before,” Broida offers.

It is not possible to talk case specifics, but it is fine to discuss the experiences and emotions involved with litigation. “Several companies have also developed peer mentorship programs specifically designed to address the concerns of emergency medicine docs in the litigation process, which can take several years,” Broida notes.

Limiting stress levels also is important. “It’s frequently helpful to lighten up on shifts for a month or so, but this is rarely possible,” Broida laments.

EPs should practice self-care and wellness before, during, and after a lawsuit. Huecker also recommends leaning on family, friends, and colleagues, especially those who are familiar with the legal process. “Physicians should seek assistance from the people and organizations that make them feel most supported,” Huecker adds.

REFERENCES

  1. Vizcaíno-Rakosnik M, Martin-Fumadó C, Arimany-Manso J, Gómez-Durán EL. The impact of malpractice claims on physicians’ well-being and practice. J Patient Saf 2020; Dec 14. doi: 10.1097/PTS.0000000000000800. [Online ahead of print].
  2. Stehman CR, Testo Z, Gershaw RS, Kellogg AR. Burnout, drop out, suicide: Physician loss in emergency medicine, Part I. West J Emerg Med 2019;20:485-494.
  3. Chen KY, Yang CM, Lien CH, et al. Burnout, job satisfaction, and medical malpractice among physicians. Int J Med Sci 2013;10:1471-1478.
  4. Ferguson B, Geralds J, Petrey J, Huecker M. Malpractice in emergency medicine — A review of risk and mitigation practices for the emergency medicine provider. J Emerg Med 2018;55:659-665.