Sara Charles, MD: “On Being a Doctor”

Dr. Plumb’s poignant account of her being sued for malpractice as a second year resident awakens memories for those of us who have been in similar circumstances. Her articulate and intimate description of her years of introspection and suffering provide of mirror for the rest of us who have trodden a similar path. Although dismissed from the case, Dr. Plum’s lingering fears and doubts about her life choice of a medical career plague her every day.

Could her experience have been different? Her learning of the suit through her mentor allows us to reflect on the role of mentors and other sources of support for physicians… especially young physicians… caught up in similar circumstances. Although the author does not share much information with us but about their relationship we can surely ask: was the mentor empathic, understanding and supportive? Or was the first encounter about the suit the last?

Just 40 years ago as a young physician in private practice, I found myself in a somewhat similar situation. I was overwhelmed with feelings of isolation, of being “different” from my peers, of anger at the seeming lack of understanding of the circumstances of the case by the plaintiff’s attorney, and the “injustice” of it all… familiar feelings to those who have been sued. In those days, there were no formal structures for mentoring but I was fortunate to have two colleagues who, in response to my approaching them, offered unstinting support. The late psychoanalyst, Lucia Towers M.D. agreed to review, on a weekly basis, all my case notes from my sessions with the aggrieved patient and the late Leroy Levitt M.D., a prominent Chicago psychiatrist, agreed to serve as an expert witness. Although their names are unknown among later generations, these two well-regarded senior leaders were willing to literally “stand with” a very young, somewhat inexperienced colleague. Having support from leaders in the professional community was of incomparable value and a major source of emotional support during my 4 ½ year litigation.

What can be learned from my own experience? I would suggest that there is no better support in a malpractice action than that offered by a respected senior colleague. Such an individual understands the medical science as well as the vagaries of practice. Such support literally “arms” you for the battle ahead and underscores some of the meanings of support – “to endure bravely or quietly;” to promote the interests or cause of;” “to uphold or defend as valid or right;” “to assist;’’ and “to act with”. (1)

Dr. Plumb has done us all a service in drawing our attention to a serious problem. I do not know if Dr. Plumb’s mentor had much interaction with her, especially as it related to her litigation experience, but I would hope that he would have made himself available for her during this period. Too many physicians, unfamiliar with the particulars of what it means to be sued and with the legal system itself, tend to shy away from having anything to do with it as though it were an infectious disease.

We have numerous young physicians who are confronted with negative outcomes and lawsuits. Increasingly, the medical literature highlights burnout and the lack of sufficient support among practicing physicians. If experienced doctors, especially those in senior positions, would reach out not only to one another but especially to young physicians who experience negative practice events and/or litigation, the emotional burden of such events could be markedly diminished. In addition, medical leaders can play a significant role in combating the development of burnout and contribute to the overall health of their physicians to the benefit of their patients by establishing policies and programs within their health care systems to support those affected by negative outcomes and litigation.

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