Navigating the emotional impact of a medical malpractice lawsuit [PODCAST]

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In this episode, we explore the emotional impact of medical malpractice lawsuits on physicians and how they can navigate the process. Attorney Christine Zharova shares her insights on how these lawsuits can affect relationships with colleagues, staff, family, friends, and the self. She emphasizes the importance of seeking support and resources during this challenging and often lengthy process. Tune in to learn more about how to cope with the stress of medical malpractice litigation and find support as a physician.

Christine Zharova is an attorney.

She shares her story and discusses her KevinMD article, “Medical malpractice is a lot like running a marathon.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Rate and review at KevinMD.com/rate. Subscribe at KevinMD.com/podcast. Today on the show we have Christine Zharova. She’s an attorney, and her KevinMD article is titled “Medical malpractice is a lot like running a marathon.” Christine, welcome to the show.

Christine Zharova: Thank you so much, Dr. Pho, for having me and letting me share my story with your audience today.

Kevin Pho: So we’ll get into the article in a little bit, but first off, briefly share your story and journey to where you are today.

Christine Zharova: Sure. My name is Christine Zharova. I am a former medical malpractice defense attorney. The first 14 and a half years of my career, I spent defending physicians, their groups, and hospitals in medical malpractice cases. Currently, I’m a business litigation attorney. I still get to help physicians with business-related questions and non-compete issues. And then this year, I became a consultant and a coach to physicians to help them navigate the medical malpractice process, the emotional and the practical aspects of it.

Kevin Pho: All right. And as you know, when you talk to a lot of physicians, that whole medical malpractice process is a little bit of a black box. So what would you say are some of the biggest misconceptions about that process that you’d like to clear up with physicians?

Christine Zharova: I think for physicians, it is because of the lack of education. I know that when physicians are going to medical school, there’s not a lot of time that is spent on educating physicians on the process. There’s a lot of shame associated with it, because there’s a lack of conversations between colleagues about what it feels like going through the process. What compounds the problem is the attorneys, who will, rightfully so, tell the physicians that are going through the medical malpractice process not to discuss the ins and outs of the lawsuit with anyone else besides their attorney.

Kevin Pho: And when you talk about the emotional impact on physicians, there’s a little bit of tension there. They’re not allowed to talk about the case with anybody else, yet sometimes they do need some emotional support, especially when they’re going through it for the first time. There are a lot of unknowns there. How can physicians navigate that tension?

Christine Zharova: Yeah, absolutely. So when your medical malpractice attorney is telling you not to discuss the lawsuit with anyone else, what they mean is not to discuss the ins and outs of the lawsuit: the medicine, the strategy, your attorney’s analysis of the exposure, things that have to do with facts and are specific to your case. That is very different from how the lawsuit is affecting you on a personal, human level, right?

So what I’ve seen from my physicians is that the stress of the lawsuit spills over into their lives. It affects their relationships with their colleagues, their staff, their family, their friends, and, most importantly, with themselves. They view themselves differently. They question who they are. They question how good of a physician they are. And so the reason why I’ve gotten into this coaching and consulting part of my life, and why I wrote this article, is because I want physicians to understand that there are resources available, that the resources are not very well known, and that physicians are still resistant to them. But it takes a village to help you get through the litigation process, which is very lengthy. From statistics, I know that physicians on average spend 10 to 25 percent of their professional life going through litigation and dedicating themselves to it. So if they’re going to spend such a large chunk of their life doing that, wouldn’t you want to get resources to help you through it?

We live in a day and age where there are resources available, right? You can Google your way through most things, except for lawsuits. I have had a lot of client physicians who told me, “When I got sued, the first thing I did is I Googled, ‘How do I get through a lawsuit?'” The problem is, when you Google that, most of the content that pops up is written from the perspective of the patient or the patient’s lawyer, which is going to make you feel like crap as a physician if you’re reading it. It’s only going to scare you more. It’s not going to give you any clarity. It’s not going to make you feel better. So that’s one of the reasons why I started writing some articles and posts on LinkedIn, to educate physicians about the process and answer some common questions they have. And I’m doing what I’m doing today, writing this article for you as well.

Kevin Pho: All right. So let’s go straight into your article, titled “Medical malpractice is a lot like running a marathon.” Tell me, how did this article come together?

Christine Zharova: So the article came together as I was writing the posts and the content on LinkedIn. In one of my posts, I forgot what it was about, I was telling physicians to brace themselves, because the process is going to be lengthy. We know the process can last three to four years. From what I’ve seen in my experience, it is now lasting a lot longer, because with COVID, trials are backed up, so the process is taking much more time. And then it hit me. I was like, “You know, it’s just like running a marathon.” It’s a lengthy process that requires training, resources, and support. And as I started to unpack that analogy some more, there were so many pieces of running a marathon and preparing for a marathon that were so analogous, and that made it so much more clear why physicians struggle as much as they do when they’re going through the process.

So when we think of a marathon runner, right, they have tools and they have resources. You can go on Google and find training plans, how to increase your speed, how to increase your miles, and what to do if you’re injured. You can find blogs of other marathoners that are going through the same thing. You’re joining marathon clubs. You can have a coach. And that’s just to run a marathon, which is a great challenge, but it’s a voluntary endeavor, versus lawsuits, which are such an inextricable part, an occupational hazard, of the job. And we don’t have many resources to help physicians with that. They have an attorney, of course, and some have a great risk management department. But attorneys, and I say this being a former medical malpractice attorney myself, your time is limited, and you’re not trained in helping physicians navigate through the process. Some attorneys aren’t comfortable getting into the warm and fuzzies. I’ve never been like that, but I know some are.

And then, as I was writing this article, I was talking to a few of my medical malpractice defense colleagues, and I was polling them to figure out how much time we spend with our doctors before we prepare them for their deposition, which happens about a year into the process, right? Most of my colleagues and I said three to five hours, max. Now, of those three to five hours, more than half, more than 50 percent of that time, is spent on reading through the medical records, talking to the physician about their independent recollection of the patient or what happened, and talking about strategies and defenses. It is not spent on education, and it’s also not spent on navigating the effect that the lawsuit is having on the physician as a whole.

Kevin Pho: So let’s walk through a hypothetical case. If a physician is involved in a malpractice lawsuit and he just got notified of it, walk me through some of the things that physician can do to make the process just a little bit easier.

Christine Zharova: Sure. So of course, there are the practical aspects of being sued. You may have just received your complaint. I know in some states it goes directly to a complaint; in other states, like Florida, we have a presuit process. So once you’re notified of a lawsuit, you want to make sure that your insurance carrier is on notice, and your insurance carrier will be in charge of setting you up with the attorney who’s going to be assigned to your case. The attorney will be in touch and tell you the plan, what to expect, and what to do. There are practical things, things that you shouldn’t be doing, and I’ll just throw a few of those out there. Obviously, don’t change your medical records. Don’t modify them. Don’t supplement them. And when you meet with your attorney, recognize and realize that you have to take the front seat in your lawsuit. You have to be an active participant in that lawsuit.

As you’re starting to get through the process, consider what resources you need, right? You know yourself. You know what you need. Don’t be afraid to realize that this is an area where you may need help, where you may need some additional guidance and some additional support. And that’s a generalization, but physicians don’t like to be vulnerable. They’re used to being in control. They don’t like to ask for help. But this is a very different process from what you’ve ever experienced. It’s a very different challenge that will undoubtedly feel extremely personal to you, because it feels like an attack on you, your skills, and your intentions, right? You try to heal a patient, and let’s say there’s a negative outcome, or a complication arose, and then the patient sues you. It feels very personal. So recognize that every physician experiences this. There will be an emotional floodgate that opens up, and you will experience quite the cocktail of human emotions that you’ve never felt before. It could be reaching out to a friend, a colleague, a counselor, or a coach, but there are resources available, and you do need a village to get through the litigation process, which is such a long journey.

Kevin Pho: So what are some of those resources that aren’t immediately apparent? You mentioned earlier that sometimes the insurance-provided attorney may not help the physician through those emotional aspects. So tell us some of those resources that physicians may not be aware of.

Christine Zharova: Yeah, and I know this is kind of a developing coaching niche, but I think there is a need for physicians to hire a coach, whether it’s for a few sessions or whether it’s ongoing as they need it during the process, because the process ebbs and flows, and so do the emotions with it. You hire a coach to help you get through the emotional aspects of it and process things that are coming up. From my perspective, having the litigation experience and the medical malpractice defense experience behind me, I know when certain emotions pop up at different stages. There are also things that I can help with from a practical perspective, not relating to your lawsuit, but, let’s say, relating to your practice, right? Let’s say the lawsuit made you realize, “I can implement a better process here,” or, “I can tweak this and that.” That’s something you can work on with a coach or a consultant.

And I think it’s just helpful, whether it’s a coach, a consultant, or another supporter, to be able to have a sounding board that feels like it’s 100 percent meant for you. It’s a safe place where you can talk about what you’re going through, talk about your feelings, talk about the thoughts that are coming up, and have someone allow you to process it in a safe place and then redirect you, so that you can be focused and objective in your process.

I called my coaching and consulting practice the Med Mal Game because, not to minimize the significance of it or the importance of it, but as personal as it feels, ultimately it is a game. There are rules. There are players. Each player has a different objective. There are tools that you can implement, if you use the resources, to allow yourself to get through the process with the least amount of impact and to get to the point of objectivity, which I know every physician has, or they wouldn’t be a physician, right? My intention is always to get the physician to realize that you are the best expert in that room, and it’s you because you have the experience and you have the knowledge. You are the only one out of any player in that game who has seen the patient, who has physically evaluated the patient, who’s gotten the patient’s history, and who has all that information. And so my thought process about coaching from my perspective has been: Let’s get you to the point where you feel so empowered and in control that you’re like, “You know what? It’s a lawsuit. It’s going to be stressful, but I got this.” Because challenges are not new to you guys. It’s just a challenge that no one really talks about and no one really thinks about until it gets there, until it hits them.

Kevin Pho: Now, short of hiring a coach, are there any simple tips that physicians can use to help manage some of these unexpected stresses and emotions that accompany a lawsuit?

Christine Zharova: Yeah, I think it’s understanding that your lawyer’s instruction not to talk about it does not include and encompass talking about the experience of it. So maybe it’s your spouse, maybe it’s your friend. Once again, don’t talk about the details of the lawsuit, but how you’re feeling through it, it’s OK to discuss.

Kevin Pho: I know there’s always an example of that. Could you give a hypothetical case study? Tell us a scenario of a physician who may be involved in a lawsuit, and just walk through what that physician can talk about.

Christine Zharova: So for example, let’s say you’re talking about your medical records, right? Obviously, that’s protected by HIPAA. We don’t want to be disclosing any confidential, HIPAA-protected information. Anything your lawyer told you, that’s protected by the attorney-client privilege; you don’t want to waive that. Anything like your thoughts about the case, like, “I’m wondering whether I should have ordered this drug or I should have ordered that drug,” don’t talk about that. You could say, “Sometimes I look back and I wonder, could I have made a different decision?” That’s something that’s fine to talk about, because it’s a very general thought that goes through every human’s head when we’re facing a challenge where something negative happened, right? “Could I have done something differently?” But when you’re putting it into the context of the details of the lawsuit, that is going to be something your attorney is not going to want you to talk about. Your attorney’s analysis of exposure or damages that could be awarded, your attorney’s analysis of the chance of prevailing at trial, you don’t want to talk about. But if you’re like, and this is what physicians usually tell me, “Man, I’m just sitting here, and it’s so overwhelming. I cannot put it out of my mind. Every day I go see my patients, and it occupies my mind,” or, “I go see my patients, and a patient reminds me in some way of the patient that sued me, or the details of that patient’s condition or plan of care are similar to the details of my lawsuit. I’m overwhelmed. I’m stressed. I’m anxious,” those are the kinds of things that you should absolutely be talking to someone about, whoever it is.

Kevin Pho: What about shared experiences, right? Sometimes that’s very helpful: maybe talking to other physician colleagues who have also undergone a medical malpractice lawsuit, and talking about some of those commonalities and shared experiences. Is something like that OK?

Christine Zharova: Absolutely. I think you can reach out to physicians. I know certain medical malpractice insurance carriers have programs that are called something like Doctor to Doctor, where they will connect you with another physician, in a different specialty, who has been through the process. And I think it’s very healing to go through the process and have a connection with someone who’s been through it. I know there are physicians who have gone on other podcasts and talked about their experience. Reach out to them. They’re going to be more than happy to talk to you about it, because I think for a lot of physicians who have gone through it and found a way to overcome it in a healthy way, they discover something else that they want to do. They discover some purpose that this lawsuit served, right? And if you could find that, or if you could just be at peace that it happened, like, “I know I can do it. I know I can get through it. I know it’s not going to get the best of me,” that’s all I would want. And certainly, connecting with your colleagues would help with that tremendously.

Kevin Pho: Now, what kind of questions can physicians ask themselves to see whether they need further coaching from someone like yourself, or whether they could handle it with the resources that they already have? What kind of questions should they be asking themselves in order to direct them to the next steps?

Christine Zharova: Yeah, I think they should ask themselves, “What is going through my mind as I’m going through the lawsuit?” Do you feel like the thoughts about the lawsuit are constantly circling? Is it a circular pattern that you’re experiencing? Are you waking up in the middle of the night thinking about the lawsuit? Do you have a lot of questions that you want a sounding board for, right? For example, if a physician works with me, there are certain questions that I can answer that have to do with the legal process in general, right? If there’s a question that I cannot answer, because it’s a question for their attorney, I can help them articulate that question for their attorney without being involved.

But I think you have to ask yourself, “How is this process overtaking my thoughts? Am I still able to perform at my job to the best level that I can? Is it making my time with my family suffer? Am I not present?” I have seen physicians who have gotten DUIs, who have gotten divorces, who have left the practice of medicine altogether, and who have shifted their practices. As you’re going through it, it may not be in the beginning, but you know when you’re really suffering through it. And I think that if you feel like you’re suffering through it, reach out for a consult and see if it’s for you. Sometimes having that consultation can help you get a feeling, a vibe, for whether or not it’s something that’s going to help you. And certainly, it helps if you need someone who’s going to help you figure out the practicalities, like, “Here’s how it’s affecting me. What do I need to do to overcome it? What are some tools and strategies I can implement so that I am doing better in this area of my life going forward, as I live my life through litigation?”

Kevin Pho: We’re talking to Christine Zharova. She’s an attorney, and her KevinMD article is titled “Medical malpractice is a lot like running a marathon.” Christine, what are some of the take-home messages that you want to leave with the KevinMD audience?

Christine Zharova: Absolutely. So my take-home message is that just because you’re sued, a lawsuit does not mean anything about you as a physician, right? Take an active role in your lawsuit, too. Get into the driver’s seat. So many physicians fade into the background, and it doesn’t serve them. It makes them feel less in control. It makes them have more questions. It causes more stress. And remember, you’re not a stranger to overcoming challenges. You’ve had those times where you’ve had to take the boards, those times where you didn’t sleep for 48 hours straight, and you’ve had to overcome more challenges than most people. And so, with that in mind, you can overcome this. This is not something that should take away from your life in the way that it sometimes does. So those would be my takeaway tips.

Kevin Pho: Christine, thank you so much for sharing your insight, and thanks again for being on the show.

Christine Zharova: Thank you, Dr. Pho. Have a good day.

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