Malpractice claims and disciplinary actions are unfortunate realities for too many physicians. A 2016 survey of physicians revealed that 34 percent of them had been sued, and 16.8 percent had been sued more than once. By the time a doctor is 54 years old, there is almost a 50 percent chance that they will have been sued. Disciplinary actions are far less common, but a comprehensive review of Illinois physicians’ licensing board data in 2021 showed that 3.2 percent of Illinois doctors had had a disciplinary action. Current estimates are that 2 to 8 percent of physicians will be subjected to some disciplinary action over the course of their careers.
There are excellent articles and resources that discuss how to survive these events from a practical perspective – don’t discuss details with anyone, look at your practices and procedures to see if you can be more defensive or protective moving forward, etc. – but few that discuss the emotional side. The vast majority of physicians experience emotional distress due to a claim or disciplinary action. Many report disruptions in their personal and family lives. Given how long and drawn out these processes can be, the distress can last for months or years, and can continue even after a positive resolution or vindication. For some physicians, the symptoms are very similar to those of PTSD, with sleep disturbances, anxiety, intrusive thoughts, feelings of detachment, worthlessness, and withdrawal from others.
When I work with physician clients facing malpractice claims or disciplinary action, I start simply by encouraging them to talk about it. Doctors often translate the attorney’s advice not to discuss the details of the case as not discussing the case at all with anyone, but keeping this to yourself is profoundly unhelpful. Silence amplifies feelings of isolation and compounds many of the emotional reactions that doctors in these situations experience. Processing the event or situation with a professional counselor alleviates the isolation: It helps remove some of the shame the person feels; it can help diffuse the intense emotions the person attaches to the situation; and, we can begin to identify other areas which might be helpful to explore. The confidentiality protections of counseling help to provide a space for this work that often cannot be found with friends, family, or colleagues.
Many physicians experience intense shame around malpractice and disciplinary issues. If they are at fault, the shame can revolve around having made an error or struggling with a substance use issue. But even when the claim is unfounded, shame is still very prominent because of the very real fear of being thought of as a bad doctor, or knowing that family, colleagues, or patients might think poorly of you. Doctors tend to be perfectionists, and being accused of making a mistake can feel threatening or excessively vulnerable. Many physicians understandably perceive these claims or investigations as questioning their integrity. Some respond with justified anger. And for many doctors, there is grief – over the loss of autonomy; loss of respect and standing; loss of sense of safety and trust in patients and systems; loss of confidence; and sometimes loss of relationships or positions. These reactions are normal and human, but if they are not processed and explored in healthy ways, they can lead to prolonged negative emotional and physical effects.
If the physician is at fault or disciplined, medical directors or licensing boards might require practice changes, supervision, and education. I work with physicians on self-forgiveness and acceptance. I emphasize that to be human is to be imperfect. We find ways to manage their fears of making future mistakes and work through any guilt or shame. We address any underlying issues, like alcohol abuse or mental illness, that might have contributed to the situation.
Malpractice claims and disciplinary actions are painful, often extended events that cause suffering for physicians. Emotional support is just as important for quality of life and moving forward as legal support is. I encourage every physician who experiences distress around these issues to seek counseling.
Vickie Mulkerin is a family physician and owner, White Coat Counseling, LLC.
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