Physicians Practice - October 2008 - (Page 46)

MALPRACTICE you to take on that risk and at what cost are you ready to buy out of that risk. That needs to be done on a case-by-case analysis.” In court, your conduct and demeanor take center stage. Angela M. Dodge, founder of Dodge & Associates Trial Consulting in Olalla, Wash., and author of “When Good Doctors Get Sued,” says physicians should project the “four C’s” at all times — competence, conﬁdence in their care, conscientiousness, and compassion. “How the jurors perceive a doctor is very important,” she says. “The jury has to believe that the doctor did everything he or she could have done to treat that patient, that they really care about what happened to their patient, and that if it resulted in a bad outcome they genuinely feel bad.” Show empathy by looking jurors and the plaintiff in the eye and using facial cues that reﬂect your concern. “The most powerful comment physicians can make to demonstrate compassion on the stand is to look directly at the plaintiff and say, ‘I’m sorry that despite the good care we were giving and all the precautions we took that Mrs. Smith had an unfortunate outcome,’” says Dodge. “You’re essentially apologizing for the outcome of the case, not the quality of care.” Note the use of the plaintiff’s name. It’s importance to address the plaintiff by name, rather than referring to her as “the patient,” which depersonalizes your comments. MANAGING MEDICAL MALPRACTICE STRESS SYNDROME B Y S H E L LY K . S C H WA R T Z You interview patients to identify the source of their complaints. You carefully review their medical charts. And you guide them toward remedies to restore their health. In short, you’ve dedicated your professional life to helping others get or stay well. But if you’re sued during the course of such care, who helps you? “Just as physicians are terrible with diagnosing physical illness in ourselves, we are terrible at diagnosing stress effects in our lives,” says Louise B. Andrew, an emergency medicine physician, attorney, and litigation counselor who founded litigation stress management ﬁrm MDMentor.com in Pt. Angeles, Wash. “We can’t look at ourselves objectively. We come out of medical school feeling somehow invincible, like we’re not allowed to experience the same stress as our patients so we deny it, even if it is staring us in the face.” Andrew educates physicians throughout the country about Medical Malpractice Stress Syndrome (MMSS), sometimes called malpractice litigation stress. The term describes a set of physical and emotional symptoms many physicians experience after being served, including gastrointestinal disorders, anxiety, insomnia, chest pain, or even heart attacks. “Malpractice suits are really a blow to the heart for most doctors,” she says. Emotionally, the most common symptoms reported include feelings of shame, bitterness, sleeplessness, negative selfimage, loss of appetite, and depression. Some physicians even self-prescribe medication to help them cope — a dicey decision. “Doctors often feel very isolated, like nobody cares about them or no one wants to help them or vindicate them,” explains John-Henry Pﬁfferling, a physician-anthropologist and founder of the Center for Professional Well-Being in Durham, N.C. ALL IN THE FAMILY abilities. Both predictable and unpredictable anger outbursts can occur if the doctor feels no sense of control,” says Pﬁfferling. “It may be directed at yourself, at your attorney, the plaintiff’s attorney, your colleagues and staff, or even your family.” What’s more, the stress of being served doesn’t just affect you. “In small towns in particular, if a news reporter gets a hold of what he or she thinks is a juicy case of malpractice and plasters your face all over the front page of the newspaper, that can result in your children being shunned by other kids in school or your spouse being shunned by others in their social groups,” says Andrew. But don’t take your frustrations out on your family, says Pﬁfferling. “Be open and transparent and let them know that you’re not sure how to deal with all this. Ask for their support.” WHAT YOU CAN DO Your ﬁrst step, says Andrew, is to acknowledge your symptoms. The next is to give yourself permission to seek help. “This is one of the times where it’s most normal to need extra care,” she says. Allow yourself to have what you need — better nutrition, more counseling, maybe some time off. “[Do] whatever produces more ease and better balance,” says Pﬁfferling. Share your angst with a spouse, psychologist, attorney, or religious leader. “One of the ﬁrst things your lawyer tells you is don’t talk to anyone,” says Andrew. “That’s a very destructive message.” They’re right, of course, that you can’t divulge case details to anyone who might later be called upon to recount the discussion under oath, but you can share your feelings with an appropriate person. Lastly, avoid self-medicating. If you think you need some medicinal shoring up while you go through this difﬁcult time, consult a personal physician. Remember, emphasizes Pﬁfferling, this too shall pass. “Nothing can undo all of the good that you have done in your chosen profession,” he says. “This is a glitch, an intrusion, an assault. Don’t give your power away.” MMSS symptoms wax and wane throughout the litigation process, depending on the physician’s self-esteem, his anxiety about the process, and his impression of his attorney 46 | PHYSICIANS PRACTICE | OCTOBER 2008 WWW.PHYSICIANSPRACTICE.COM http://www.MDMentor.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - October 2008

Physicians Practice - October 2008 Contents Another Reason to Go Cash-Only? Letters How ’Bout Them Gas Prices? Second Opinion: Oh, Canada! Noteworthy Cover Story: Fixing the Leaks: How to Tighten Your Money Spigot Navigating a Lawsuit Ask the Experts The Administrators Desk: What’s Your Mission? EMR: Help or Hindrance? Dealing with Dr. Dangerous E-Mail Abuse Primer The Road to EMR Interoperability Don’t Let Staff Costs Stifle Profits Coding Classifieds Advertiser Index

Physicians Practice - October 2008

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