When medicine meets litigation
Managing the professional and personal impact of claims and complaints
Enore Panetta
Director, Panetta McGrath Lawyers
Being the subject of a claim or complaint can have significant professional and personal impacts. Doing their best and practising to high standards is ingrained in health practitioners – so those who are sued or have a complaint against them usually perceive it as an assault on their own integrity.
This perspective is entirely understandable; after years dedicated to improving patient outcomes and providing compassionate care, having your clinical judgment questioned can feel deeply personal and profoundly unfair.
Most doctors will face at least one complaint or claim during their career. This is particularly true for those in high-risk specialties such as obstetrics, neurosurgery and emergency medicine, although practitioners in all fields remain vulnerable.
Understanding that litigation is common can help contextualise what feels like a singularly devastating experience.
The emotional cost
Seeing your name on the initial claim or complaint, especially when associated with alarming legal terms – like negligence, below standard of care, or unprofessional – may trigger a rollercoaster of emotions such as shock, anger, fear and anxiety, guilt, shame, defensiveness, a desire to give up practice, and overwhelming stress.
You may feel like you’ve been kicked in the gut; lose sleep, become irritable with staff or family, feel constantly distracted, second-guess your decisions, or struggle with self-doubt. Unfortunately, these feelings can resurface with every new document or communication from your lawyer, reigniting the emotional turmoil.
A defendant health practitioner may often harbour fears of disastrous personal consequences – such as loss of reputation, desertion by patients, suspension or deregistration. Many dread the possibility of adverse media coverage and the impact it might have on their career and standing in the community.
Some practitioners cope reasonably well and can compartmentalise the issue, allowing their medical defence organisation (MDO) to manage the matter. However, others may retreat, avoid engagement and find it hard to face the reality – which often exacerbates the stress and delays resolution.
To complicate matters, complaint resolution and litigation timelines are often slow and frustrating – even where the allegations are unfounded. The uncertainty and unpredictability of the legal process can be unsettling, especially for those unfamiliar with legal procedures and terminology.
Adding to this the unpredictability of whether a case will proceed to the next step, when it will happen, and what the ultimate outcome might be. Fear of the unknown causes further distress, and it contributes to a sense of helplessness or loss of control.
“ Litigation is one of the most stressful events a practitioner can face – but it is survivable, with the right support and strategies. Many practitioners emerge from the experience wiser, more cautious, and equipped with better risk management tools for the future.
The effect on clinical practice
One of the most concerning aspects of litigation stress is its impact on subsequent clinical practice. Many practitioners report changes in their practice patterns following a claim or complaint.
This “defensive medicine” manifests in various ways:
- overordering diagnostic tests and procedures;
- referring more frequently to specialists, even for straightforward cases;
- avoiding high-risk patients or procedures within their specialty;
- excessive documentation that focuses more on legal protection than patient care; or
- diminished therapeutic relationship with patients due to heightened suspicion.
These changes not only increase healthcare costs, but may paradoxically decrease quality of care. The practitioner who once practised with confident compassion may become hesitant and overly cautious, potentially delaying necessary interventions or creating a less supportive patient experience.
The effect on the conduct of the defence
In my experience, health practitioners who struggle to manage the stress of litigation often make less-effective defendants. Their ability to meaningfully engage in the defence can be compromised by the emotional burden.
A practitioner may withdraw, lose perspective, or become so overwhelmed that they inadvertently obstruct the legal process. Heightened stress can lead to dysfunctional or irrational behaviour – for example, withholding information, altering records, or contacting the complainant, even after being advised not to do so. In extreme cases, some practitioners may misuse alcohol or drugs to self-soothe, which can lead to further disciplinary issues.
These actions can cause serious repercussions, including additional complaints to Ahpra or new legal claims, compounding an already stressful situation. Emotional reactivity often complicates what might otherwise be straightforward cases. When practitioners attempt to manage their anxiety through counterproductive behaviours like altering documentation after the fact,
they transform potentially defensible cases into problematic ones.
Stress-related health issues are also common. It is not unusual for litigation to contribute to physical illness, burnout or clinical depression. Tragically, in rare but devastating instances, the psychological toll may lead to suicide.
Coping with the stress
Being named in a claim or complaint is an intensely challenging experience, but it is one that can be navigated with the right support and mindset.
Consider the following strategies:
- Seek professional help if you need support – including from your general practitioner or a psychologist. Individual counselling can provide perspective as well as tools for coping. Many MDOs now offer psychological support services specifically tailored to practitioners facing litigation.
- Avoid self-medicating with alcohol or substances.
- Maintain your physical health. Exercise regularly, eat nutritious food, and prioritise rest and sleep.
- Engage in your own defence. Work constructively with your solicitor – explain the clinical context, help to identify relevant literature, and suggest expert witnesses. This collaboration can give you back a sense of control and reduce feelings of powerlessness.
- Stay informed. Ask questions and make sure you understand the legal process. Knowledge of what to expect can reduce anxiety and improve your confidence.
- Speak openly with trusted colleagues, family, friends and medico-legal advisers. Isolation can intensify emotional distress.
- Don’t take the matter personally. Even the most careful, competent and compassionate practitioners can face claims or complaints. It is an occupational hazard, not a reflection of your worth or professionalism. Remember that patient complaints often stem from communication issues rather than clinical competence.
- Maintain perspective on the likelihood of outcomes. Most complaints do not result in serious professional consequences. Only a small percentage of complaints to regulatory bodies result in significant disciplinary action. Understanding this reality can help manage catastrophic thinking.
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The content of this article is intended to provide a general overview and guide to the subject matter. Specialist advice should be sought about your specific circumstances or situation.