Dealing with the stress of litigation and complaints

The emotional cost

Seeing your name on the initial claim or complaint associated with alarming legal terms like negligence, below standard of care, or unprofessional may cause a rollercoaster of emotions: shock, anger, fear and anxiety, guilt, shame, defensiveness, wanting to give up practice, and increased stress.

You may feel like you’ve been kicked in the gut, lose sleep, get angry with staff and family, feel distracted, second-guess yourself, or have self-doubt. Unfortunately, those feelings can be re-experienced with every new document or communication from your lawyer about the legal matter.

A defendant health practitioner may often harbour visions of disastrous personal consequences – such as loss of reputation, desertion by patients, suspension or deregistration. They also dread the possibility of media coverage.

Some health practitioners cope reasonably well and are able to address the issues, leaving their medical defence organisation to handle the matter. However, others go into a shell and don’t want to face reality – as a result, the issues only get worse for them.

To complicate matters, often claims and complaint resolution times and processes can be frustratingly slow (even when there is little substance to the allegations). The delays can cause more stress.

The legal process and procedures can also be difficult to understand for someone not familiar with the rules, as well as being unpredictable.

Added to this is the uncertainty at any stage that a case will proceed to the next step; and if so, when; and what the outcome might be. Fear of the unknown causes the health practitioner further stress and can make them feel like they have no control over the events or process being faced.

The effect on the conduct of the defence

In my experience, health practitioners who don’t cope well with their litigation-caused stress tend to make less than optimal defendants.

Often, due to their feelings, a defendant health practitioner will withdraw or go into isolation. They may lose perspective about the litigation. This usually then impedes the health practitioner’s ability to effectively assist in the defence of the claim or complaint during the legal process. Increased stress may also trigger dysfunctional or irrational behaviour.

For example, the health practitioner might lie, conceal things, or even alter the clinical records. They may contact the plaintiff or complainant, despite having been warned not to do so. Sometimes a defendant health practitioner may abuse alcohol or drugs in an attempt to self-medicate to alleviate stress. These sorts of behaviours can result in additional lawsuits and complaints to the Medical Board.

The stress of being sued or complained about sometimes also directly contributes to physical illness of the health practitioner. Tragically, if their reaction is extreme, depression may lead to suicide.

Coping with the stress

Being named in a claim or complaint is a difficult process, but there are ways to successfully manoeuvre through this minefield. Here are some coping strategies that can be used to counteract the stressful characteristics of litigation and complaints:

• Seek professional help if you need support, perhaps from your own general practitioner. Individual professional counselling can also be of great benefit.
• Do not self-medicate, or use substances or alcohol to alleviate stress.
• Look after yourself, including exercise, eating well, and getting adequate sleep.
• Participate actively in your own defence. Educate your solicitor about the clinical matters involved in the case, and assist with identifying expert witnesses and relevant literature. Working closely with your solicitor in this way can reduce feelings of helplessness and restore feelings of self-esteem, confidence and control. Most solicitors will welcome the assistance and knowledge you can provide.
• Ask questions and stay informed about the legal process and procedure. This can be helpful in educating yourself about the legal system, and addressing your fears and concerns about the litigation. Knowing what to expect will allow you to prepare and feel more in control, which usually diminishes anxiety.
• Talk openly about how you’re feeling with your colleagues, family, friends and medico-legal advisers. Do not isolate yourself.
• Resist taking the allegations personally. The most ethical and competent health practitioners can be sued or complained about. Remind yourself frequently that the threat of a claim or complaint is a well-established occupational hazard of practising medicine.

Litigation is one of the most stressful events in the life of any health practitioner – but it is survivable and surmountable. At the end of the process, you may be able to learn from the experience and adopt risk management strategies for the future.

The content of this article is intended to provide a general overview and guide to the subject matter. Specialist advice should be sought about your specific circumstances or situation.

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