By the time you reach age 55, 18% of your pediatrician colleagues – or you yourself – will have been sued for malpractice. As many as 64% of your brother and sister obstetrician-gynecologists will have suffered the same fate. These numbers come from a pool of recent data released by the American Medical Association that suggest that nearly half of physicians in this country will be sued for malpractice by age 55 years.

A related release by the AMA details the outcomes and financial costs of malpractice suits between 2006 and 2015 ( “Medical professional liability insurance indemnity payments, expenses, and claim disposition, 2006-2015,” by Jose R. Guardado, PhD, AMA Policy Research Perspectives, 2018). In a press release accompanying the publication of these two studies AMA President David O. Barbe, MD, MHA, observes, “Even though the vast majority of claims are dropped, dismissed, or withdrawn, the heavy cost associated with a litigious climate takes a significant financial toll on our health care system when the nation is working to reduce unnecessary health care costs.”

I have read the AMA’s press release and the two studies several times and didn’t see a single reference to the emotional toll taken on the health care providers who have been sued. Of course, although it is easy to imagine that the human cost of a malpractice suit is probably high, it is not one of those figures that the number crunchers can find in their data sets and spreadsheets.

As someone who has endured a malpractice suit that went to trial, I can bear personal witness to the emotional challenges that come with litigation. Although a case that goes to trial is unusual (7%), most cases like ours are won by defendants (87.5%). That number was of little or no reassurance to me and my codefendants. Every waking hour during the 7 years that it took our case to play out was darkened by the threat to my professional career. Every trip to the mailbox was an exercise in courage. Would there be another piece of voluminous communication to remind me of the terrible reality?

Thanks to my wife and a lawyer who was always concerned about how I was doing emotionally, my story had a happy ending. I survived with my solo practice and my marriage intact. But I know that others have not been as lucky. Chemical dependency, divorce, poor productivity, and early retirement are just part of the underreported collateral damage that can come in the wake of a malpractice case, even one that is resolved with a relatively small financial cost.

Beyond the emotional cost, there is the staggering expense of defensive medicine. It has been going on for so long that many physicians practicing today don’t realize they are practicing defensive medicine because that’s the way they have been taught by several generations of gun-shy mentors.

And, of course, the risk-averse mentality is one of the drivers of the tsunami of computerization that threatens to drown our health care delivery system. The fallacious legal argument that if it wasn’t documented, it didn’t happen, has resulted in a glut of computer-enhanced “documentation” that even the most casual observer realizes isn’t worth the electrons it takes to light up the pixels on a computer screen.

Even if we ignore their incalculable emotional costs, malpractice suits and the litigious climate in which we practice are eating away at our health care delivery system. I certainly don’t have the answers to rein in the costs. I only can recommend that you practice the best medicine you know how, and do it in a manner that demonstrates you care about the patient. And hope you have good lawyer who cares about you more than his fee.

Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine, for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Email him at .


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