Expired CME Article

Psychologic Effects of Poor Outcome and Professional Liability Actions on Physicians

Authors: Cecile B. McAninch, PhD, Suneet P. Chauhan, MD, Everett F. Magann, MD, Vidya B. Chauhan, MD, Jacob A. Brown, MD, John C. Morrison, MD


Objectives: Little is known about the psychologic effects on obstetricians and gynecologists of adverse maternal or fetal outcome and malpractice claims.

Methods: An anonymous survey regarding the psychologic effects of professional liability claims, as measured by 19 items which were used to create four composites rated on a 5-point scale, was mailed to the members of the Central Association of Obstetricians and Gynecologists.

Results: Among respondents, 78% had at least one malpractice claim, and 9% experienced a patient death, 12% a fetal demise, and 21% neonatal neurologic damage. In general, professional liability claims had significant effects on psychologic trauma (P < 0.001), shame/doubt (P < 0.005), and active coping (P < 0.05), but not on job stress, whereas patient death, but not fetal death or neonatal neurologic injury, had significant effects on all 4 composite variables.

Conclusion: Physicians experience psychologic trauma influenced by patient death and professional liability actions.

Key Points

* Obstetricians and gynecologists are likely to be sued, as 78% have at least one professional liability claim during their practice.

* Among those experiencing a professional liability claim, there were significant effects indicating psychologic trauma, shame/doubt, inactive coping, but oddly enough, not job stress.

* Physician experience of maternal death had a significant effect on all composite variables.

* Physicians experience psychologic trauma influenced by patient death in professional liability actions.

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