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Item Establishing a Novel Group-based Litigation Peer Support Program to Promote Wellness for Physicians Involved in Medical Malpractice Lawsuits(University of California, 2023) Doehring, Marla C.; Strachan, Christian C.; Haut, Lindsey; Heniff, Melanie; Crevier, Karen; Crittendon, Megan; Nault Connors, Jill; Welch, Julie L.; Emergency Medicine, School of MedicineIntroduction: Being named as a defendant in a malpractice lawsuit is known to be a particularly high-stress and vulnerable time for a physician. Medical malpractice stress syndrome (MMSS) is a consequence of being named as a physician defendant in a malpractice lawsuit. Symptoms include depression, anxiety, and insomnia, which may lead to burnout, loss of confidence in clinical decision-making, substance abuse, strain on personal and professional relationships, and suicidal ideation. Although the legal process requires strict confidentiality regarding the specific details of the legal case, discussing the emotional impact of the case is not prohibited. Given that physicians often do not choose formalized therapy with a licensed professional, there is a recognized need to provide physicians with options to support their wellness during a lawsuit. Methods: The peer support model is a promising option to address the negative impacts to wellness that physician defendants face during medical malpractice lawsuits. We developed and implemented a peer support program to provide a safe, protected space for discussion of the personal impact of a lawsuit and to normalize this experience among peer physicians. Results: Physicians were receptive to joining a peer support group to discuss the personal impacts of being named in a medical malpractice lawsuit. Participants in this novel group-based program found it helpful and would unanimously recommend it to others who are being sued. Conclusion: To our knowledge, this pilot study is the first to implement and assess a facilitated, group-based peer support model for emergency physicians who are named as defendants in malpractice lawsuits. While group discussions demonstrated that symptoms of acute distress and MMSS were prevalent among physicians who were being sued, in this study physicians were receptive to and felt better after peer support sessions. Despite increasing burnout in the specialty of emergency medicine (EM) during the study time frame, burnout did not worsen in participants. Extrapolating from this pilot program, we hypothesize that formal peer support offered by EM groups can be an effective option to normalize the experience of being sued, promote wellness, and benefit physicians who endure the often long and stressful process of a medical malpractice lawsuit.Item The Impact of Defense Expenses in Medical Malpractice Claims(Cambridge University Press, 2012) Carroll, Aaron E.; Parikh, Parul Divya; Buddenbaum, Jennifer L.; Pediatrics, School of MedicineThe objective of this study was to take a closer look at defense related expenses for medical malpractice cases over time. We conducted a retrospective review of medical malpractice claims reported to the Physician Insurers Association of America’s Data Sharing Project with a closing date between January 1, 1985 and December 31, 2008. On average a medical malpractice claim costs more than $27,000 to defend. Claims that go to trial are much more costly to defend than are those that are dropped, withdrawn, or dismissed. However, since the overwhelming majority of claims are dropped, withdrawn, or dismissed, the total amount spent to defend them surpasses that spent on claims that go to trial. Defense attorney expenses account for the majority of defense related expenses (74%), while expert witness expenses and other expenses split the remaining 26%. A strong association was also found between the average indemnity payment and the amount it costs to defend individual claims by specialty. Our study found that defense related expenses for medical malpractice claims are not an insignificant cost. As state and federal governments debate how to repair the malpractice system, addressing the high cost of defending claims should not be ignored.