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Litigation Stress and Burnout

Introduction

Stress—whether it is situational or long-term (commonly referred to as burnout)—is an ongoing challenge for practicing physicians and healthcare professionals. Working conditions including staff shortages and heavy workloads, and the reality of a litigious environment, can all contribute as ongoing stressors in healthcare settings. The National Institute for Occupational Safety and Health (NIOSH) and other organizations have been instrumental in raising awareness about workplace stress. These groups are prescribing actionable approaches for healthcare leaders and organizations to help them improve wellbeing for workers.

Handling Litigation Stress from a Defense Attorney’s Perspective

Mr. Walter William Bates (Billy), Esq, has been a partner at Starnes Davis Florie for over 35 years and served as the firm’s Managing Partner from 2006 to 2016. His practice has been devoted to civil litigation to include medical professional liability, pharmaceutical liability, medical device and other healthcare litigation. He has tried more than 140 complex civil cases to a jury verdict, including cases in defense of physicians, hospitals, product manufacturers, and corporations.

 

Litigation Process from a Physician Perspective 

Mary Ellis, MD

Mary Ellis, MD, an EICU physician who provided remote monitoring and oversight in conjunction with onsite ICU staff. Dr. Ellis was involved in a case naming all physicians and bedside staff members involved in the episode of care. She describes her initial reaction to being named in a lawsuit and cautions and advises physicians who provide consultations in any form and how that potentially may affect the defense of a claim. Dr. Ellis describes the result of the trial and what it was like to wait for the jury's decision.

Michael Canady

Michael Canady, a surgeon shares his experience when he was named in a lawsuit and provides advice on the importance of the informed consent process, especially in elective cases, interacting with family members, the importance of accurate and timely dictation of the operative report, and describes the hardest part of the litigation process.

Dr. David A. Rogers

Dr. David A. Rogers, a professor in the departments of surgery, medical education, and pediatrics, and UAB Medicine Chief Wellness Officer, discusses stress and burnout and the framework from an organizational perspective. He discusses the signs of burnout that physicians, colleagues, and their families should be aware of. Dr. Rodger shares his experience with burnout and how it may affect medical care. He also provides techniques to gain resilience, available resources, and research that may be helpful to physicians experiencing stress and burnout.

The Physician Litigation Stress Resource Center

The Physician Litigation Stress Resource Center is a not-for-profit website that provides physicians and other healthcare professionals the resources they need to understand and cope with the personal and professional stress created by involvement in a medical malpractice case or an adverse outcome that may result in litigation. This site directs practitioners to articles, books, and websites addressing the process of litigation and suggests strategies for coping with litigation-related stress. Also listed are resources that may provide support for physicians and other healthcare practitioners throughout the ordeal of litigation.

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Gita Pensa, MD

CDD6DEC1-A433-43D7-9715-8CB8F81A3AC1Gita Pensa, MD, is an emergency physician practicing in Rhode Island since 2001. She graduated from the University of Pennsylvania School of Medicine (now Perelman School of Medicine) in 1997. She continued to residency at the combined George Washington/ Georgetown Emergency Medicine Residency in Washington, D.C., graduating as Chief Resident in 2001. She worked in community emergency medicine for 13 years before joining the faculty at the Warren Alpert Medical School of Medicine of Brown University in 2014. She is currently an Adjunct Associate Professor in the Department of Emergency Medicine.

In addition to physician defendant wellbeing coaching and consulting, Dr. Pensa was the host and editor of AEM Early Access, a research podcast of the Academic Emergency Medicine journal, through 2024. She is also a regular contributor to Emergency Medicine Reviews and Perspectives and the co-host of its UC Max program. At the medical school at Brown University, she served as a Mary B. Arnold Longitudinal Mentor to over 40 medical students yearly until 2022.

Physicians may access Dr. Pensa’s website to review the resources available or to seek counseling services independently or by working with their defense attorney during the litigation process.

You may contact Dr. Pensa directly by emailing doctorsandlitigation@gmail.com or by filling out the website form.

Podcasts

Dr. Pensa publishes an ongoing series of podcasts dedicated to exploring malpractice litigation and litigation stress. In this series, Dr. Pensa interviews physicians who have been there and provides advice from experts, including psychologists and attorneys. The L Word podcast series discusses malpractice litigation and litigation stress. Start with the introduction of Season 1 and work your way through.

Dike Drummond, MD

dikedrummondmd-200w_optDr. Dike Drummond is a Mayo-trained Family Practice physician, burnout survivor, executive coach, and founder of TheHappyMD.com. He teaches simple methods to lower stress, build more life balance, and develop a more ideal practice. These tools were discovered and tested via Dr. Drummond’s 3,000 hours of physician coaching experience. Since 2010, he has also delivered live burnout prevention training to over 40,000 physicians on behalf of 175 corporate and association clients on four continents.

Physicians may access Dr. Drummond’s website to review the resources available or seek counseling services independently or by working with their defense attorney during the litigation process.

You may contact Dr. Drummond directly by emailing thehappymd@gmail.com, using the website form, or calling 206-430-1905.

Stress & Burnout

Dr. Drummond provides services that focus on stress management, life balance, physician burnout, practice and workflow efficiency, and Quadruple Aim physician leadership training.

David A . Rogers, MD

Picture1-1Dr. David A. Rogers is a professor in the departments of surgery, medical education, and pediatrics. He was named the UAB Medicine Chief Wellness Officer and the ProAssurance Chair for Physician Wellness in 2018. Dr. Rogers received his medical degree from the University of South Florida and completed his general surgery training at the Medical College of Georgia. He subsequently completed his pediatric general surgery training at the University of Tennessee and Pediatric Surgical Oncology fellowship at St. Jude Children’s Research Hospital. He received a Master of Health Professions Education degree from the University of Illinois Chicago and a Master of Arts degree in Sociology from the University of Alabama at Birmingham.

You may contact Dr. Rogers by emailing darogers@uab.edu or calling 205-934-8744.

Endowed Chair for Physician Wellness

Dr. Rogers, in collaboration with ProAssurance, was acknowledged with appreciation as the Endowed Chair for Physician Wellness at the University of Alabama at Birmingham (UAB).

Physicians have always been subject to the high levels of stress from a variety of factors such as society's expectations for successful outcomes, the threat of litigation and the effect of their professional obligations on the quality of their lives, and their families' lives. As medicine evolves to address the changing dynamic of healthcare in America, we must find ways to address these pressures. - Stan Starnes, Former ProAssurance Chairman and Chief Executive Officer

Articles and Research

Dr. Rogers’ research has been focused on medical education and clinical pediatric general surgery. His past educational research programs have focused on feedback, technical skills instruction, and conflict management. His clinical research projects have investigated innovations that advance the quality of surgery in this unique patient population. Dr. Rogers’ clinical interest spans across the spectrum of general pediatric surgery.

Dr. Rogers has maintained an ever-expanding body of scholarly articles and creative works over the span of his career.

Podcasts and Videos

  • A PBS special titled A Word of Hurt: How Medical Malpractice Fails Everyone examines the devastating impact of medical malpractice on patients, doctors, and society. View three powerful stories from patients and physicians who have been directly affected.
  • The L Word podcast series discusses malpractice litigation and litigation stress. Start with the introduction of Season 1 and work your way through. Hear from physicians who have been there and get advice from experts, including psychologists and attorneys.
  • This version of the Physicians on Purpose Podcast features an interview with Gita Pensa, MD, with Dike Drummond, MD, as the interviewer.
  • ProAssurance two-minute video, Unexpected Outcomes, here.

Other Resources