Medical liability suits can mean depression, suicidal ideation for doctors

Doctors who are sued commonly have career burnout, depression and increased thoughts of suicide, a new study says.

Surgeons who experienced a recent medical liability lawsuit also reported less career satisfaction and were less likely to recommend a medical career to their children, according to the study in the November Journal of the American College of Surgeons (link).

"Today, it is very easy to get sued," said lead study author Charles M. Balch, MD, a professor of surgery at the University of Texas Southwestern Medical Center. "There is a price that's paid by surgeons going through the malpractice experience."

Researchers from John Hopkins Medical Institutions in Baltimore and Mayo Clinic in Minnesota analyzed 7,164 surveys returned (out of 25,073 sent) in 2010 to members of the American College of Surgeons. Doctors were asked whether they were involved in a medical liability lawsuit in the last two years. Physicians also were asked about demographics, practice characteristics and quality-of-life issues associated with litigation.

Of the respondents, 25% were involved in a recent lawsuit. Data showed that surgeons who experienced litigation tended to be younger, worked longer hours, had more evening shifts and were more likely to be in private practice. Of surgical specialties, 31% of neurologic surgeons experienced a recent medical liability lawsuit, 29% of cardiothoracic surgeons noted recent litigation, and 28% of general surgeons experienced a recent lawsuit.

Twenty-eight percent of colorectal and obstetric and gynecologic surgeons had been sued recently. Surgical specialties with the lowest rate of lawsuits were otolaryngology and ophthalmology surgeons, both at 12%. Fourteen percent of breast surgeons reported recent litigation.

Doctors sued had a 7% higher rate of burnout than other physicians and about a 10% higher rate of experiencing symptoms of depression, the study said. Surgeons who were recently sued also had an increased rate of suicidal ideation: 6.4% compared with 4% of other doctors. Surgeons who experienced litigation also cited lower career satisfaction.

Authors noted that the study did not distinguish the nature of the litigation or the lawsuits' outcome. In addition, physicians who had been sued were not asked to rate their feelings of burnout and depression before their lawsuits began.

Study authors point out that burnout can adversely affect the quality of care surgeons provide and is strongly associated with an increased risk of medical errors.

Communication among medical professionals about burnout and depression is key to reducing the negative effects of being sued, Dr. Balch said. More states also should implement more tort reforms, such as damages caps, to prevent frivolous lawsuits, he said.

"I hope there'll be more discussion among practices and hospitals about how to mitigate the stress that's inherent to an ongoing lawsuit and explore the ways to reduce the accusatory nature of medical malpractice" litigation, he said.