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During practice, physicians experience a repeated loop of conducting procedures, performing physicals and identifying symptoms. These experiences become a routine part of their daily lives. Doctors know what to expect for the most part, what to do, what may challenge them and what is easy. Depending on their specialty, physicians experience a minimal amount of the unexpected.
This is not the same experience when a physician receives a summons, an indicator of being sued for malpractice. This experience is out of the ordinary. The brain does not necessarily know what to expect, do, or what's ahead with this experience. Thus, the body's fight-or-flight response is triggered. Although this response may be activated during the day-to-day experiences, the impact of the response may be minimal. This may be because the physician in the day-to-day experience allows for the necessary recovery period to occur when the fight-or-flight response triggers. For most unexpected experiences, this may not be the case.
The impact of such an experience varies from physician to physician; however, the cascade of fight-or-flight chemicals, the psyche's ability to block the experience and the physician's general coping abilities all play a part in how this experience affects him or her.
An increase in the body's fight-or-flight response may result in deceased appetite, muscular tension, increased heart rate, shallow breathing, racing thoughts and decreased sleep. With an extended period of time of these chemicals and stress effects, physicians may suffer from depression, exhaustion, various physical diseases of adaptation, anxiety, insomnia, intense shame and guilt, burnout and compassion fatigue.
So what can physicians do in order to reduce the impact of a possible perceived traumatic event? The following tips may be helpful:
Acknowledge the fact you may be experiencing stress. Physicians commonly expect themselves not to experience a normal and programmed response to a perceived threat-that somehow they don't and "shouldn't" experience this. It's important to recognize that you are not immune to the evolutionary survival mechanism of the fight-or-flight response. Acknowledging you are experiencing stress can be the first step in taking proactive steps to reducing the effects.
Recognize distorted thought patterns. Distorted thought patterns may feed into the belief that "this can never happen to me." These patterns tend to be unrealistic and may actually increase anxiety levels, stress, depression and anger. Black-and-white thinking, overgeneralizations and other such patterns are examples of unrealistic thinking. Recognizing that being sued is a possibility-and even a probability-according to some research can go a long way in the impact of receiving a summons.
Be involved in what's happening. Avoiding the suit does not make it go away and may even reinforce the sense of feeling helpless, hopeless and powerless. It's common to want to avoid the situation that's triggering stress, but this does not allow you any sense of control or knowledge about the situation. It may allow a temporary sense that usually doesn't last. Knowing where you stand, your options and what's happening in the day-to-day occurrence of the suit may help reduce the shock and unexpected feelings that may occur.
Get support. Although you may be advised to keep all information relating to the case private, you can express the emotions and reactions the case elicited. You can talk about your shock, what the case means to you, about you and how it affects your beliefs about your work and profession. These are not "facts" about the case per se. Yet these are important issues to discuss and process, whether it's with other physicians, a trained professional or a support group. Recognizing you are not alone, that your reactions are common and that there is hope are important aspects of receiving positive support.
Keep some routine and balance. Continue socializing, relaxing and engaging in family activities. When something unexpected and stressful is present, having a routine helps normalize part of the day. This allows some sense of control over what's happening and what you're choosing to be a part of. Continue to take care of yourself.
Malpractice suits do not have to be like the tiger in the bushes that you're unprepared for. Having the knowledge of what is involved in a malpractice suit, what to expect and your options can go a long way in managing the impact. Developing the skills to manage the stress of malpractice suits is another method of managing the effects. Maintaining a realistic and proactive attitude can only further your ability to thrive amid a malpractice suit.
Serena Wadhwa Psy.D., LCPC, CADC, is an expert in chronic stress, burnout and compassion fatigue management. As the owner of TriQual Living Center in Chicago, Wadhwa provides a holistic approach to managing stress through workshops and individual and group therapy. For more information, visit www.triqualiving.com.
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