3 ways to manage effects of medical malpractice stress syndrome

Medical malpractice stress syndrome (MMSS) is a particular manifestation of stress that physicians facing malpractice suits may experience, but there are at least three ways to manage it, a Yale researcher suggests.

Understanding how to address symptoms of the syndrome is important, as 90% of radiologists will be sued at least once by the age of 65, wrote author Jonathan Mezrich, MD, an emergency radiologist at the Yale School of Medicine in New Haven, CT. His viewpoint was published June 18 in the American Journal of Roentgenology.

"Radiologists may be at inherently high risk of a malpractice suit because of the sheer volume of cases interpreted and lack of goodwill from patients given limited direct interactions," Mezrich noted.

MMSS can cause "significant emotional, behavioral, and physical symptoms, and can lead to job dissatisfaction, burnout, depression, and even suicidal ideation," he explained, and listed the following symptoms:

• Anxiety, depression, shame, and anger. "Because radiologists have spent such a large portion of their lives developing their radiology skillset, they often consider their profession as integral to their identity, making it difficult to differentiate an objective legal claim from a personal attack," he explained.
• Hypersensitivity to criticism, burnout, and feelings of inadequacy. "Those who have been sued may subsequently find themselves practicing very differently, whether second-guessing every decision, becoming slower to issue or sign reports, or losing confidence in clinical decision-making," Mezrich noted.
• Physical conditions such as insomnia, gastric ulcers, and cardiomyopathy-related changes. "Clearly, lawsuit-related stress can have severe health manifestations," he wrote.

But there are measures radiologists can take to either ward off or cope with MMSS, according to Mezrich. He offered three broad suggestions:

1. Get educated. Despite the significant consequences of medical malpractice on a medical career, many radiologists receive little teaching on the subject," he noted. He urged his colleagues to be "proactive in engaging with the available medicolegal literature and attending relevant lectures at professional society meetings," and "once sued, a radiologist should consult a legal professional or risk manager, who will be instrumental in navigating the process."
2. Establish a support system. Friend and family support is key, and radiologists' institutions may also offer peer support groups for those undergoing litigation. It's also important to have access to mental health resources, Mezrich noted.
3. Support tort reform. Tort reform "could potentially lessen the impact of MMSS on radiologists while maintaining a fair system for patients," he wrote.

"Given the realities of clinical practice, radiologists will inevitably commit errors and be at risk of a lawsuit … [and] radiologists may experience MMSS because of such a lawsuit, with potentially severe personal and professional consequences," Mezrich concluded. "[But there are at least] three approaches that could be pursued at individual, specialty, and societal levels for mitigating these."

The complete article can be found here.