“I remember precisely where I was when I found out,” said Simon G. Talbot, MD, associate chief of plastic surgery at Mass General Brigham in Boston, of the first time he was named in a lawsuit. “I got home at night, and someone had managed to get inside my building and nailed the document to the door of my apartment,” recalled Talbot, who was a trainee at the time. “The process by which you find out about these things is horribly negative.” He was later dropped from the case. Still, he said, the experience “does not leave you.”

“Being sued often leaves a lasting mark, and most doctors practice differently afterward in some way,” said Annia Raja, PhD, a licensed clinical psychologist who specializes in therapy for physicians. She said she has even seen doctors leave the field due to the emotional toll of litigation.

If you’re sued, your lawyer will offer strategies and advice. But addressing your mental health around the experience is equally important. In fact, you may be shocked just how overwhelming the emotional avalanche can be. It’s common to experience something akin to Elisabeth Kübler-Ross’s “five stages of grief.” The experience of being sued is so difficult that there’s even a label to describe it: medical malpractice stress syndrome.

“Most physicians experience [being sued] as a kind of trauma,” said Raja. “And it honestly is. There’s shock, fear, anger, deep self-doubt, anxious rumination, physical symptoms of distress, flashbacks.”

Here’s a guide to coping when the (almost) inevitable occurs.

Shock

“It was about 6 PM and I had to sign for a letter at the front desk of my apartment building,” said Talbot, of the second time he was named in a lawsuit. The details are still fresh in his mind, even though the events occurred nearly 20 years ago. “I opened the letter and was just speechless,” said Talbot, now also associate chief medical officer at Brigham and Women’s Hospital. “I can’t even describe the emotion. I was so upset by the circumstances; it took me several weeks to put it out of the front of my mind.”

A patient was suing Talbot “2 years and 51 weeks” after Talbot had taken him to the operating room to remove stitches that had become infected. The patient’s suture abscesses were a known complication of a procedure that Talbot and a surgeon colleague had performed on him months earlier. By then, the initial surgery was outside of the statute of limitations, but the stitch removal was not. So Talbot alone was named.

Ultimately, the suit wasn’t dropped until right before the scheduled court date, several years later. That’s a lot of waiting — and a lot of angst.

Strategy: Remember Just How Common This Is

Unfortunately, being sued is all too common for doctors. By age 65, 75% of physicians in low-risk specialties and 99% of doctors in high-risk specialties will face a claim, according to projections published in The New England Journal of Medicine.

Understanding how common (if not inevitable) being sued is at some point in your career can help make the experience less destabilizing, said Raja. If it happens, remember that you are in good company. And as you’ll see, the reality is probably not as bad as it feels.

Fear

“This is the worst fear for the vast majority of physicians,” said Gail Gazelle, MD, MCC, a hospice physician who has coached hundreds of doctors and is on the faculty at Harvard Medical School in Boston. “Their worst fear is materializing, and unfortunately their mind goes to the worst-case scenario.”

An emergency room (ER) doctor Gazelle coached several years ago “went into a state of panic” when he found out he was the secondary target of a lawsuit. “He thought to himself, I’m going to lose everything, I’m going to lose my job, I won’t be able to pay my mortgage. My face will be plastered across the news. People will think I am deviant and rogue and won’t go near my door. He was on high alert thinking about what shoe would drop next and who would come after him next.” As Gazelle, also co-author of Mindful MD: 6 Ways Mindfulness Restores Your Autonomy and Cures Healthcare Burnout, notes: “Our mind takes us to these incredibly catastrophic places.” 

Strategy: Focus on Data, Not Emotions

“Just because you were named doesn’t mean that you are going to end up on the stand in court,” said Wendy Dean, MD.

“Ninety-nine percent of cases don’t go to trial,” said David N. Vozza, Esq., a member of the Healthcare Practice Group at Norris McLaughlin in New York City and general counsel to the Medical Society of the State of New York. They’re either dropped or settled.

In 2023, the average settlement payout per claim was $420,000, according to The Doctors Company, one of the largest medical malpractice providers. That’s within the $1 million in legal fees and awards or settlements covered by most malpractice insurance policies, said Vozza.

Among cases that do go to trial, 85%-90% are won by physician defendants, reported the American College of Emergency Physicians.

Self-Doubt

“Lawsuits often attack a doctor’s core identity as a competent caregiver,” said Raja. “Doctors who were once decisive and confident in their clinical decision-making start second-guessing every choice, no matter how big or small.”

“You immediately start thinking, ‘How did I miss it? Was there anything I should have done differently?’” said Dean, co-founder (with Talbot) of the nonprofit Moral Injury of Healthcare, about the time she learned she was being sued.

When Dean was an ER doctor, a patient sued Dean even though the patient’s primary care physician (PCP) had been responsible for the mistake.

“The patient was unwilling to sue the person who made the mistake because that was her beloved PCP,” recalled Dean. “I was just the ER doctor who doesn’t live in the community and who has no relationship with her.” Still, Dean experienced a “whole self-doubt spiral…. It goes right to your reptilian brain. Every time we get sued, we have been taught that it says something about who we are and how we practice.”

Strategy: Don’t Take It Personally

“Many doctors internalize lawsuits as personal failures rather than systemic failures,” said Raja. But the healthcare system sets physicians up for litigation, with scant safeguards against frivolous lawsuits and by treating medicine as a form of customer service, she added.

As Dean points out, doctors — as faces of healthcare organizations — are natural scapegoats for lawsuits. “Patients have little recourse other than suing physicians if they are unhappy or something goes wrong,” she said.

But the reality is each doctor only has a certain amount of control. “Almost always, when you dig into [a case], there was a whole cascade of challenges,” said Dean. “You were at the end of that cascade, but you were not the only person responsible.”

Anger

“I was mad,” said Dean. “It was a setup, and I was the fall guy.”

Her feelings were typical. After being named in a lawsuit, resentment can rise up, whether toward the legal and healthcare systems or patients. “This can feel especially unnerving for people like doctors who often enter medicine out of a deep desire to care for others,” Raja said.

Even when lawsuits are resolved, doctors can “still have an aching feeling inside that the individual should not have gotten a penny becaus e they did not do anything wrong,” said Vozza. Typically, malpractice insurance providers can settle without the consent of the doctor being sued.

Strategy: Self-Audit Your Skill Set

“Ruminating about it will not make it go away,” said Dean. “It will not make you find new approaches or answers. It will just ruin the life you are living right now.”

Instead, remind yourself of your resilience, experience, and dedication to medicine, said Gazelle. “Doctors have faced a lot of challenges to survive medical school and training. Quiet your nervous system by reminding yourself, ‘I have been through a lot of hard stuff and survived…. I will get through it, even though it seems like horrible territory.’”

You can also try distracting yourself with your usual coping mechanisms, which in Dean’s case meant running and hiking. “Whatever got me out of breath and sweating,” she said.

Betrayal and Disillusionment

Many doctors also grieve “the loss of professional innocence and the sense of safety they once had in their work,” said Raja.

That was the case for Dean. “It was such a rupture of a collegial relationship,” she said of the lawsuit. “The PCP never contacted me and said, ‘Hey, you are taking the hit for this, and I am sorry.’ I knew them, and they never reached out.” She had to swallow her frustration and sense of betrayal and continue working with this colleague.

Strategy: Find Support

“[Being sued] is a very ostracizing, isolating event,” said Dean. “It’s a hard thing because sometimes you cannot talk about the case. But even if you can’t talk about it specifically, you can find support.”

And you should. Commiserating with other doctors — even without discussing details that might jeopardize the case — can be deeply therapeutic. “Shame is such a common response for doctors in these circumstances, and shame is a breeding ground for isolation and despair,” said Raja.

A Rite of Passage

“There is still a nail hole in my apartment door,” said Talbot. He won’t forget the two times he was named in a lawsuit. But he has accepted these stressful experiences as part of the travails of a career in medicine. Perhaps even a rite of passage. And the hole? “Maybe I’ll just paint over it,” he said.