There is ample evidence that an adverse event, the threat of litigation or, of course, litigation itself causes significant emotional distress to any healthcare practitioner who may be involved. Because of several factors (shame and/or humiliation, the fear of discoverability of conversations, or the lack of training of peers to effectively support each other), individuals often suffer these emotional strains in silence. This stress has been shown to increase the risk for additional therapeutic misadventures, increase the risk for quitting medicine at an early age, and, in some cases, even contribute to suicide. What can the organization, no matter what its size, do to offer adverse event and/or litigation support for individual practitioners?
The following is a brief outline of suggested steps for support of litigation and adverse outcome emotions:
- One or more individuals, depending on the size of the organization, should receive basic training in litigation stress support. This basic training need only to identify a point person (the group litigation support mentor) in the group who is aware of the potential for emotional distress and has knowledge of various community resources that might be needed.
- Every lawsuit or potential lawsuit, ideally, requires a meeting with the group litigation support mentor and, if indicated, the defense attorney for the clinic or the case. At the time of this meeting the following is discussed: 1) the flow, pace, logistics, and components of a lawsuit (deposition, settlement, trial), 2) what one can expect with regard to emotions, stress and possible symptoms, 3) confidentiality issues, and 4) dealing with medical records, correspondence, and meetings with patients and their family and plaintiff attorneys.
- Discussions should occur about personal lifestyle issues and how they are likely to be affected during the litigation experience. Included here is advice regarding exercise, substance abuse, anxiety, evaluating one’s work load to maintain a healthy balance without unwarranted increases or decreases in volume, additional referrals and emotional support, avoidance of fatigue, increased vulnerability to errors, family support issues, and long term expectations and recovery.
- Finally, there should be ongoing short check-in meetings with the group support person. These should even continue after the case is resolved on a less regular basis.
This approach is obviously more difficult for the solo practitioner, but even in small groups the ability to discuss stress, maintenance of a balanced lifestyle, and management of the flow of events will help put these trying events into perspective and allow a more reasonable response and recovery for the practitioner who experiences them.