The psychological impact of complaints and negligence suits on doctors.
OBJECTIVE
To describe the psychological impact of complaints and negligence litigation on doctors.


METHODS
A review of the literature from 1966 to 2003 was conducted. Additional sources were obtained from targeted experts and organizations.


RESULTS
Doctors who have been sued or who have had formal complaints made against them describe the process as an extremely stressful experience. Depression and adjustment disorder were relatively common, while drug and alcohol abuse, physical illness and suicidal ideation were reported less frequently. The majority of doctors who have been the subject of a complaint or law suit practice more 'defensively'.


CONCLUSIONS
A complaint or law suit is uncommon in the daily practice of doctors, yet in today's medicolegal environment they pose a constant potential threat. The threat of, or actual, legal process can cause psychological, physical and behavioural practice changes. The obsessional personality of many doctors may make them particularly vulnerable to seeing the process as a challenge to their professional and personal identity.
Nash
Louise
L
Department of Psychological Medicine, University of Sydney, Sydney, NSW, Australia. lnash@med.usyd.edu.au
Tennant
Christopher
C
Walton
Merrilyn
M
D001291:Attitude of Health Personnel; D001315:Australia / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence*; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data*