November 2003

Can lightning strike twice?

by Timothy Feuling

Today, it's almost a given. At some point in your career as a doctor of chiropractic, you will be sued for malpractice. Despite the trauma involved, most D.C.s recover both financially and emotionally. In fact, many actually feel "safer." After all, what are the chances that lightning will hit twice and they'll be sued again?

According to several major research studies, the chances may be higher than you think.

PICOM Insurance Co., for instance, found that about 14% of its physician clients who had been sued for malpractice reported they were sued again within three months after the first suit began. Although the figure declined slightly over the next few months, it spiked about a year later ‑‑ just about the time the plaintiff's expert witnesses were giving their depositions!

Theodore L. Passineau, J.D., senior health care advisor to PICOM and the study's author concluded: "I can say with confidence there is a statistical relationship between being sued and the chance of being sued again."

Although there's no way to definitely determine the reason for the repeat lawsuits, one strong possibility is the increased stress experienced by the doctors. Medical doctors have known this for years. The American Medical Association Board of Trustees has stated: "The biggest cost of suits brought under the malpractice system is the emotional injury that a physician experiences when he or she believes that he or she has done the best possible under difficult circumstances." The stress reaction is so well documented and common that there's even a name for it: "malpractice stress syndrome."

Several articles in CBS Reports (www.cbsmalpractice.com/report) have explored the relationship between stress and the likelihood of malpractice claims, so it's no surprise that doctors suffering from the strain of a malpractice lawsuit ‑ even if it doesn't lead to court ‑ can behave in ways that increase the risk of additional malpractice accusations.

This is true whether the claim was justified or frivolous. If the doctor was at fault in the initial lawsuit, he or she may be working through guilt and suffering a lack of self confidence that can be all too obvious to patients. If a doctor doesn't have confidence in his or her ability, the patients won't either.

If the lawsuit was unfounded, the doctor's residual anger and resentment can create a hostile atmosphere and spark patient dissatisfaction ‑ and another complaint.

Although nothing will completely erase the stress of being sued, it's important to be aware of the impact that stress will have on your life and your practice, and take proactive steps to minimize it. Most experts suggest discussing the situation with a few close and respected colleagues, to gain a measure of perspective on the situation. Keep a positive attitude and continue being involved in the hobbies and activities that bring you the most satisfaction. Take a stress management course if possible, or see a psychologist or therapist if you find yourself obsessing over the lawsuit.

As attorney Randall Kleinman noted in a report for The Rough Notes Magazine: "Above all, remember that the only thing truly important about being sued is how you feel about it. If you let it put your feelings in a tailspin, then you've let the plaintiff extract far more than he or she deserves to get!"

SOURCES: "Recognizing the Symptoms of Malpractice Stress Syndrome,"

by Kenneth C. Olson, M.D., M.S., Psychiatric Times, April 2000, Vol. XVII, Issue 4.

"Vicious circle: Stress of one lawsuit can put physicians at risk for another," by Deborah Gesensway, ACP (American College of Physicians) Observer. Feb. 1995.

"The psychology of being sued: A look at the stress and anxiety of litigation," by Randall Kleinman, J.D., CPCU, CLU, The Rough Notes Magazine, 1998.