Dealing with Litigation Stress
Dealing with Litigation Stress | Malpractice Emotional Stress, Dr. Roland Gray, Tennessee Medical Foundation, Physicians Health Program

Dr. Roland Gray
Tips for Coping

For physicians who have been sued for malpractice, this isn’t news: It’s an extraordinarily stressful situation.

What is news is the growing recognition that many providers need help to emotionally navigate those treacherous malpractice waters. In Tennessee, that help might come from the Tennessee Medical Foundation and its Physicians Health Program, led by Medical Director Roland F. Gray, MD. Gray is one of the speakers this spring and summer at a series of statewide risk management seminars sponsored by State Volunteer Mutual Insurance Co. Entitled “Anatomy of a Medical Malpractice Lawsuit,” the two-hour panel discussions offer an educational overview of the emotional aspects of being sued, the legal process and how to cope with and effectively participate in the litigation.

“We’ve long recognized the malpractice stress syndrome,” Gray said. “Studies show that most physicians at some point in their career probably will be sued for medical malpractice, and it can be very difficult emotionally.”

While there are certain personality traits common among most doctors, some of those characteristics don’t help physicians when they are under the strain of a lawsuit. “Most of us are perfectionists. It’s a personality trait that serves us very well in other aspects of our career,” Gray said. “But this perfectionism, as you’re going through malpractice litigation, can cause a gut-wrenching and unnecessarily painful self-evaluation.”

Another trait that gives physicians problems is their natural role as caretaker; thus, a malpractice suit “feels like a personal attack,” Gray added.

While not every doctor has a severe emotional or physical reaction to being sued, studies have shown that about 95 percent of doctors do have a significant reaction. “The feelings rank in intensity with the death of a loved one, going through a divorce or the onset of a life-threatening illness,” Gray said. “A major depressive episode is not uncommon. About 40 percent of the physicians at some point will meet the DSN4 criteria for major depressive disorder.”

Some physicians try to deal with the stress by suppression and denial, but that strategy “doesn’t work for the long haul,” Gray said. Instead, the Physicians Health Program recommends several coping skills.

Top of the list is encouraging physicians to “take charge of their practice and take some time off to reevaluate their priorities,” Gray said. That means working on relationships with the important people in their life. “They may take the biggest toll of this,” Gray continued. “They’re the ones who put up with the irritability, the lost nights’ sleep, the cancellation of vacation plans at the last minute and just other intrusions on their personal life.”

Adding to the difficulty between physicians and their loved ones, Gray said, is that the doctors can’t discuss the specifics of the malpractice case with their family members, who want to feel like they are “part of the healing process.”

Gray also encourages physicians to do what they often recommend to their patients: get plenty of rest and exercise. He added that a reflective life helps.

 “I find that physicians who have a strong meditative or spiritual life get through these difficulties in much better shape,” he said.

Finally, Gray recommended physicians reevaluate their priorities in the midst of this taxing situation. He said many physicians suffer from what’s called a “psychology of postponement” – once I get through medical school, I’ll take time off; once I finish my training, I’ll take some time to smell the roses; once I get my practice established, I’ll spend more time with my family; once I make partner, I’ll finally take that big vacation. “There’s always something that interferes with a physician enjoying life today. So I encourage physicians very much to develop a life outside of medicine,” he said.

And there’s a reason for that. “Never are the things in life that give us meaning, gratification and balance more important to maintain than during the stress of malpractice litigation,” Gray said. “The good news is that physicians do survive lawsuits, and our goal has always been to see that physicians get through this with the least damage done.”




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