After Philip D'Arrigo, M.D., was sued for malpractice several years ago, he "almost had a nervous breakdown," the Bridgeton, N.J., OB/GYN recalls. "When you are sued, you go through disbelief, anger, self-doubt, self-examination," D'Arrigo says. "I went through each stage."
While the soaring financial cost of medical malpractice has been making headlines these days, the emotional toll that lawsuits take on physicians is rarely aired in the popular or trade press.
D'Arrigo's experiences are typical when doctors are sued, says Dan Shapiro, a psychologist at the University of Arizona in Tucson who treats physicians who are sued. Shapiro has written a book about one such physician, Delivering Doctor Amelia.
"You have folks who have immersed themselves in their careers, who have been garnering most of their self-definition in their job," Shapiro says. "To be accused of being careless, uncaring and sloppy is a tremendous blow to them.
"It's likely that their confidence will be affected by the experience," he says. "Their practice proficiency will be affected."
The D'Arrigo case involved results of a 1994 lab test; the sample was cancerous. The results were delayed for months, and the patient later died.
In 1996, a laconic sheriff's officer walked into D'Arrigo's back office with a subpoena. For that much, D'Arrigo says, he was thankful. At least his patients in the waiting room didn't have to see him served.
D'Arrigo says the hardest part of the case was not the four-year wait before going to trial, but the five days in 2002 he spent on the witness stand. "The plaintiff's attorney makes you look like a rogue," he says.
D'Arrigo says he and his attorney agreed they had a strong case, but after the patient's two grown sons got on the witness stand and wept for their deceased mother, his insurer agreed to settle for $700,000.
Shapiro advises physician leaders to be mindful that doctors who have been sued are likely to become much more cautious and less efficient, which could be viewed as a problem by their partners as well as employer.
He advises that physician executives be patient and give these doctors moral support.
Tell them "I want you to know we really believe in you," he says.
Doctors who have been sued for malpractice should visit a mental health professional at least once to talk about the experience, Shapiro says. He says that's the rule for faculty physicians at the University of Arizona.
The good news, he says, is that the problem often diminishes once the doctor regains self-confidence.
Physician executive Donald E. Casey Jr., M.D., empathizes with doctors who have been sued. He's been there himself.
Casey, the chief medical officer of Catholic Healthcare Partners, a hospital system based in Cincinnati that operates in more than five states, says he has been a defendant twice--and exonerated both times, but not without going through a great deal of distress.
One case involved a woman who had suffered neurological damage during childbirth and spent several weeks in the OB unit. She was transferred to an internal medicine unit, where Casey was a third-year resident.
Though he was not involved with the previous care that was the basis of the lawsuit, he was named as a defendant because he wrote the discharge summary from the medical floor.
A decade in limbo
The lawsuit was filed two years after he finished his training. After 10 years, his name was dropped from the list of defendants. But until then, he says, each time he applied for a job, a license or hospital privileges he had to report that he had a malpractice lawsuit pending against him.
In another lawsuit filed against him, Casey says the plaintiff's attorney got the wrong Dr. Casey.
It took him about three years and several thousand dollars in legal costs to be dropped from that lawsuit.
Casey says even the doctors who had a direct link to these lawsuits were not guilty of malpractice. "All the doctors I know who have ever been sued, it's always been a case of being caught in a bad situation," says Casey, who advocates improving systems that catch errors rather than punishing doctors.
Casey says Catholic Healthcare Partners does not have specific programs to help doctors who have been sued, but doctors can enroll in a program at the Ohio State Medical Association, and some malpractice insurers offer seminars for newly sued doctors.
When physicians are sued, "they have to carry these things along with them for years," Casey says.
Leigh Page, a former Modern Physician reporter, is a freelance healthcare writer based in Oak Park, Ill. He can be reached at [email protected]