Medical malpractice stress syndrome in theory and practice – a narrative review

Abstract

Accusations of medical malpractice, increasingly common among healthcare professionals, are a massive source of stress which can lead to the development of medical malpractice stress syndrome (MMSS). The symptoms of this syndrome are often compared to those in post-traumatic stress syndrome (PTSD), and the doctors are referred to as “second victims” of medical mistakes. The aim of the publication is to highlight MMSS, its symptoms, its similarity to PTSD, its consequences, and methods of prevention and management. In addition, attention was paid to the number of medical malpractice lawsuits among medical specialties mostly affected by this problem to illustrate the scale of the phenomenon. The publication is a narrative review. Medical databases (PubMed, ResearchGate, Biblioteka Nauki), termedia and Jurnals.viamedica service from the years 1988–2023 were reviewed. The MMSS manifests itself with symptoms such as anger, frustration, anxiety, guilt, sleeping disorders, loss of self-confidence, and depression. Later, somatic symptoms, such as cardiovascular, also appear. The MMSS may lead to unnecessary ordered examinations, delayed therapeutic processes, or premature retirement from the profession. Recently, patients have become more aware of their rights, resulting in an increase in malpractice lawsuits, particularly in specialties such as gynecology and obstetrics, neurosurgery, and radiology. Concerns about the legal consequences of medical errors may affect future specialization choices. Graduates tend to avoid specialties with a high risk of medical malpractice. Coping with MMSS requires social support and cooperation between doctors and lawyers or psychiatrists. Prevention of MMSS includes awareness of stress reactions and procedures decreasing the risk of committing medical malpractice. The prevalence of MMSS among physicians and the impact of the risk of medical malpractice lawsuits on the choice of medical specialty in Poland require further examinations. Med Pr Work Health Saf. 2023;74(6):513–26.

Keywords

• medical malpractice
• post-traumatic stress disorder
• medical malpractice stress syndrome
• litigation stress
• medical malpractice management
• second victims