What Is Medical Malpractice Stress Syndrome?

By the age of 65, over 75% of physicians in lower-risk specialties and 99% in higher-risk areas of medicine will have been sued. With most doctors likely to encounter a medical malpractice suit, it would seem to be an inevitable part of the profession, and the reason for malpractice insurance. Many people facing litigation develop Medical Malpractice Stress Syndrome (MMSS), a condition also referred to as Litigation Stress Syndrome. It is described as being similar to Post-Traumatic Stress Disorder (PTSD), which traditionally impacts those who were subjected to traumatic or devastating experiences in military combat and survivors of horrific or catastrophic auto accidents. 

Many of those who struggle with MMSS explain that they view the lawsuit as a personal attack that challenges their professional competency. In extreme cases, the condition can cause doctors to internalize these feelings and adversely affect their health and ability to practice medicine.

Symptoms of MMSS

• Depression
• Shock
• Shame & guilt
• Outrage & anger
• Tension & Fatigue
• Inability to sleep
• Gastrointestinal problems
• Chest pain
• Feelings of isolation & negative self-image

Doctors Leaving Medicine

Although it is rare and is not a viable or reasonable option for most, MMSS is one of the many reasons why a physician may decide to leave the field. Other leading reasons cited for those prematurely exiting the profession include financial problems associated with insurance payers, imposing administrative & regulatory burdens, and feelings of “burnout” from years of significant stress. The turnover rate in 2009 among physicians was 5.9% and in 2013 it rose to 6.8%, which is relatively low compared to other professions. For example, 18% of nurses leave their first jobs in the first year, and the turnover rate in retail, hospitality and food service can range from 30 to 60%.

Behavioral Responses

Physicians who are among the small segment of those who develop MMSS may respond to the problem in various ways. Many practitioners begin to refine how they practice by transitioning to a more defensive or conservative approach. These individuals may begin viewing those they treat more as potential sources of liability than patients or clients. They may begin ordering much more screening and testing, or reducing the scope of services offered in their practice. Many experience emotional pain and may begin drinking too much, working too much, or ignoring their personal relationships. Such insecurities cause many to have difficulty focusing and doubt their professional ability.

Coping/Treatment

The physician will likely be unable to openly discuss the details of the case based on restrictions concerning ongoing litigation. Other options may include talking about thoughts and concerns with a spouse or seeing a counselor or psychologist for a confidential discussion. Acknowledging feelings of depression and anxiety is critical. Try obtaining knowledge and a better understanding of the basis for the litigation in discussions with your legal counsel. If concerns such as MMSS exist, it may be best to seek medical and psychiatric assistance and/or try doing physical activity for relieving the physical and/or emotional effects.