sued feels alone and isolated from his or her peers,
family, and friends because of allegations of having
done something inappropriate or wrong.
Among health care professionals, the threat of a
malpractice lawsuit is particularly serious. For mental
health professionals, being named in a malpractice
suit can have particular professional consequences
beyond what usually happens to other defendants.
Since 1986, any entity making payments in settlement
of a malpractice claim (unless the payment is made by
the mental health professional on his or her own
behalf) must report the provider and case details
to the National Practitioner Data Bank (NPDB).
Furthermore, credentialing bodies (e.g., hospitals,
group practices, licensing authorities) are required by
law to query the NPDB when considering the qualifi-
cations of a mental health professional applicant.
Surveys such as that done in 1979 by Mawardi in
the Journal of the American Medical Association have
found a high rate of concern over the threat of mal-
practice litigation among physicians; some respon-
dents actually contemplated giving up the practice of
medicine. These surveys have also indicated that over
half of all physicians practice “defensive medicine” so
as to avoid or minimize the risk of legal action.
Defensive practices include limiting practice by not
performing certain high-risk procedures, ordering
medically unnecessary tests to document clinical
judgments, and even turning away patients seen as
potentially litigious. Williams, in a 1981 article in the
Journal of the Arkansas Medical Society, termed
physicians’ fear of malpractice litigation “paranoia
malpracticum.” A similar term “litigaphobia” was
later coined by Stan Brodsky.
Being sued for malpractice has indeed been shown
to be an emotionally traumatic experience for physi-
cians and for mental health professionals as well. The
initial reaction to being named in a malpractice suit is
often a high level of anxiety, accompanied by feelings
of righteous indignation, anger, and vindictiveness.
Self-esteem may also be affected. Such stressful
effects may be heightened by a loss of social support
similar to that often experienced in divorce, as well as
the uncertainty engendered by the possible impact thatthe legal action may have on the professional’s life
and career.
In addition to the significant physical and psycho-
logical responses to malpractice litigation, mental
health professionals are more likely to stop seeing
patients who seem to have a greater risk of experienc-
ing a bad outcome or of propensity to initiate a suit.
These mental health professionals are more likely to
consider early retirement and to discourage their own
children from entering the medical profession. In a
1988 survey of psychologists, fear of litigation was
an acknowledged reason for the use of sound risk-
management techniques. After being sued, many men-
tal health professionals begin to keep more meticulous
records, order more tests and consultations, and
stop performing procedures that may result in
risk even when they are appropriate and performed
competently.Solomon M. FuleroSee alsoPersonal Injury and Emotional Distress; Victim
Participation in the Criminal Justice SystemFurther Readings
Breslin, F., Taylor, K., & Brodsky, S. (1986). Development of
a litigaphobia scale: Measurement of excessive fear of
litigation. Psychological Reports, 58,547–550.
Charles, S. (2001). Coping with a medical malpractice suit.
Western Journal of Medicine, 174,55–58.
Charles, S., & Kennedy. E. (1985). Defendant: A psychiatrist
on trial for medical malpractice.New York: Free Press.
Lewis, B. J. (2004). When the licensing board comes a
“calling.”Bulletin of the Psychologists in Independent
Practice, 24,2–4.
Mawardi, B. (1979). Satisfactions, dissatisfactions, and
causes of stress in medical practice. Journal of the
American Medical Association, 241 , 1483–1486.
Wilbert, J., & Fulero, S. (1988). Impact of malpractice
litigation on professional psychology: Survey of
practitioners. Professional Psychology: Research and
Practice, 19,379–382.
Williams, J. (1981). Paranoia malpracticum. Journal of the
Arkansas Medical Society, 78,265–269.Litigation Stress——— 461L-Cutler (Encyc)-45463.qxd 11/18/2007 12:43 PM Page 461