How a Lawsuit Can Break a Doctor — and What to Do About It

Medscape

2 days ago

In 2018, Samuel Kaufman, MD, specialist in gynecology and obstetrics, published a book titled Delivering Justice , in which he recounted his 15-year ordeal through a legal battle that he ultimately won — but at great emotional cost. The introduction notes that the physician became emotionally involved in the case and was pulled out of his comfort zone, and that the anxiety experienced during legal proceedings as a defendant was exhausting.
In many parts of the world, lawsuits for medical malpractice have become increasingly common. In Mexico, for example, standards of accountability in healthcare have broadened, and there are now multiple legal avenues through which patients can file complaints when they feel inadequately treated. This has led to malpractice suits becoming more routine.
A review conducted in India in 2024 explored the intersection of terms such as negligence, malpractice, litigation, and consequences. The review identified 17 relevant articles and concluded that legal cases involving healthcare professionals have a significant negative emotional impact. Not only can these situations lead to stress and guilt, but in extreme cases, they have even been associated with suicide. The authors argue that more research is needed to better understand how these proceedings affect health professionals.
In 2000, Albert Wu, MD, MPH, professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health, coined the term 'second victim syndrome' to describe a condition experienced by healthcare workers who have committed a medical error and suffer psychological trauma as a result. The symptoms often include emotional distress, cognitive disruptions, and burnout, which can increase the likelihood of future errors.
Although second victim syndrome and stress resulting from a medical negligence case are not the same, it's clear that both errors and legal issues in day-to-day practice can harm clinicians' mental health.
A 2009 article described the natural course of recovery from second victim syndrome, outlining six phases:
Chaos and response to the incident; Intrusive reflections; Restoring personal integrity; Enduring the inquisition; Receiving emotional first aid; and Moving forward.
Today, it is increasingly likely that healthcare professionals will, at some point, face legal proceedings related to medical negligence. This makes it all the more important to understand the emotional toll of these processes and how to respond to them.
Some hospitals have introduced morbidity and mortality conferences where clinicians' decisions are reviewed and mistakes are openly analyzed. Such discussions are valuable for improving the quality of care and preventing future errors, but little attention is paid to the emotional and psychological impact on the physicians involved.
Sometimes, as in cases of second victim syndrome, negative emotional responses can occur even in the absence of a lawsuit. It is crucial that we continue discussing clinical errors within healthcare institutions while ensuring these conversations do not further heighten emotional distress for the people involved. These meetings should not feel like an inquisition.
With regard to medical liability, much research has focused on the specialties most often sued, the economic impact of claims, and the relationship between quality of care and liability judgments. However, there is a notable lack of research on how litigation affects healthcare workers and their performance after they are notified of a legal complaint.
It is difficult to offer general recommendations on this issue, because each case is unique. In my opinion, feelings of guilt or anxiety after a serious error or in the face of litigation are normal. Personally, I would be concerned about someone who felt no such emotions at all — or who felt them only minimally.
My first recommendation is to seek psychological support. The second is to obtain medical liability insurance, especially because many malpractice cases are handled in civil court and carry financial consequences. If we can reduce the fear of losing our assets through proper insurance, that may help alleviate some of the stress of being involved in legal proceedings.
Today, lawyers need primary care physicians just as much as physicians need legal counsel.
Mauricio Sarmiento Chavero is a physician, lawyer, and author. He currently runs a medical liability law practice. His latest published book is El estatus jurídico del médico residente en México (The Legal Status of Medical Residents in Mexico).