Supporting Emergency Physicians Through Litigation Stress

Diana Savitzky
Jennifer Goebel

It’s a busy time of year, volumes are high, patients are boarding, and then you learn you’ve been sued for the first time. Many emotions and questions run through your mind:

• Why me?
• Did I do something wrong?
• What happens now?
• Will this affect my career?
• Should I talk to someone about this?
• How will this impact my confidence at work?
• What do I tell my family?
• Am I the only one going through this?

Many of us have unfortunately been through this situation, and you are not alone.

Fear of litigation remains one of the most significant stressors for emergency medicine physicians. The high-stakes, high-acuity nature of the specialty places clinicians at risk for malpractice claims, often regardless of the quality of care provided. This constant threat contributes to chronic stress and emotional exhaustion, key drivers of burnout. Many physicians report that anxiety about potential litigation affects their well-being, influences clinical decision making, and shapes their day-to-day experience in the emergency department.

For some clinicians, the stress of litigation can become overwhelming and difficult to manage alone. An allegation of medical malpractice—or accusations of unprofessional or unethical conduct—can be deeply traumatic for physicians, regardless of the claim’s merit. The emotional impact of being sued is real and can be profoundly destabilizing.

This experience is often described as Medical Malpractice Stress Syndrome (MMSS). MMSS commonly presents with psychological symptoms such as acute or chronic anxiety, depression, sleep disturbance, and emotional exhaustion. These psychological effects may, in turn, manifest as physical symptoms or exacerbate preexisting medical conditions. Left unaddressed, MMSS can significantly impair both personal well-being and professional functioning.

Key Principles to Remember

• Medical malpractice litigation is inherently stressful and emotionally taxing.
• Being accused of malpractice can be deeply traumatic, even when the physician has provided appropriate care.
• Psychological symptoms are the most common and prominent manifestations of MMSS, often accompanied by physical symptoms.
• Physicians experiencing litigation stress must recognize that their reactions are valid and common.
• Support is essential and should be sought from trusted family members, friends, professional colleagues, and legal counsel.
• Education about MMSS is critical in helping physicians understand and manage the fear and uncertainty associated with litigation.
• It is important to remember that being sued is, unfortunately, a predictable occupational hazard in modern medical practice—and not a reflection of competence or character.

Managing Medical Malpractice Stress

Experts emphasize that effective management of MMSS begins with understanding and normalization. Dr. Louise B. Andrew, a recognized leader in this field, has outlined four essential strategies for addressing litigation-related stress:

1. Replace mystery with knowledge by understanding the legal process and what to expect.
2. Replace shame with confidence through education and support.
3. Gain insight into the key players and stages of the legal process to reduce fear of the unknown.
4. Develop tools and strategies to manage both the emotional and physical stress associated with litigation.

The ACEP Professional Well-Being Committee and the ACEP Professional Wellness Section continue to prioritize reducing workplace stressors by advancing the ACEP Well Workplace Framework, which was developed by the ACEP Professional Well-Being Committee. A central focus of this work is addressing operational contributors to clinician distress, including fear of litigation. By promoting evidence-based practices that strengthen psychological safety, enhance support systems, and embed well-being into departmental structures, organizational leaders can equip emergency physicians with the tools and education needed to thrive in a demanding practice environment.

At Northwell Health, the Emergency Medicine Service Line has taken a proactive approach by launching litigation support sessions. Two sessions have been delivered so far, one in April 2025 and another in November 2025, led by experts from Risk Management who reviewed the anatomy of malpractice cases and best practices in documentation. Feedback has been overwhelmingly positive, with physicians expressing increased confidence, strong appreciation for transparent dialogue, and requests for more frequent sessions. CME credit was offered, and post-session surveys showed measurable improvements in clinicians’ comfort and understanding of litigation processes. These sessions highlight an emerging best practice: providing structured, supportive education on a topic that affects every emergency medicine clinician yet is rarely addressed openly.

ACEP, the ACEP Professional Well-Being Committee, and the ACEP Professional Wellness Section are here to support you. Please reach out if you need support or guidance: 

Need Support? Start Here

• ACEP Wellness Section
• ACEP Well Workplace Policy
• AMA Well-Being Tools
• Lorna Breen Foundation: Removing Mental Health Stigma
• ACEP Litigation Stress: A Primer
• Medical Malpractice Stress Syndrome (MMSS)

We would love to learn what your site is doing to support clinicians experiencing litigation-related stress: ACEP Wellness Section engagED

Keep a lookout for ACEP’s Professional Wellness Section’s Wellness Week 2026: January 12–16 - a week of simple prompts to support one another, spark reflection, and care for the caregivers.