title: Personal consequences of malpractice lawsuits on American surgeons.
abstract: BACKGROUND
  Our objective was to identify the prevalence of recent malpractice litigation against American surgeons and evaluate associations with personal well-being. Although malpractice lawsuits are often filed against American surgeons, the personal consequences with respect to burnout, depression, and career satisfaction are poorly understood.
  
  
  METHODS
  Members of the American College of Surgeons were sent an anonymous, cross-sectional survey in October 2010. Surgeons were asked if they had been involved in a malpractice suit during 2 previous years. The survey also evaluated demographic variables, practice characteristics, career satisfaction, burnout, and quality of life.
  
  
  RESULTS
  Of the approximately 25,073 surgeons sampled, 7,164 (29%) returned surveys. Involvement in a recent malpractice suit was reported by 1,764 of 7,164 (24.6%) responding surgeons. Surgeons involved in a recent malpractice suit were younger, worked longer hours, had more night call, and were more likely to be in private practice (all p <0.0001). Recent malpractice suits were strongly related to burnout (p < 0.0001), depression (p < 0.0001), and recent thoughts of suicide (p < 0.0001) among surgeons. In multivariable modeling, both depression (odds ratio = 1.273; p = 0.0003) and burnout (odds ratio = 1.168; p = 0.0306) were independently associated with a recent malpractice suit after controlling for all other personal and professional characteristics. Hours worked, nights on call, subspecialty, and practice setting were also independently associated with recent malpractice suits. Surgeons who had experienced a recent malpractice suit reported less career satisfaction and were less likely to recommend a surgical or medical career to their children (p < 0.0001).
  
  
  CONCLUSIONS
  Malpractice lawsuits are common and have potentially profound personal consequences for US surgeons. Additional research is needed to identify individual, organizational, and societal interventions to support surgeons subjected to malpractice litigation.
authors: Johns Hopkins Medical Institutions, Baltimore, MD, USA. charles.balch@utsouthwestern.edu
authors: Charles M
authors: CM
authors: Balch
authors: Michael R
authors: MR
authors: Oreskovich
authors: Lotte N
authors: LN
authors: Dyrbye
authors: Joseph M
authors: JM
authors: Colaiano
authors: Daniel V
authors: DV
authors: Satele
authors: Jeff A
authors: JA
authors: Sloan
authors: Tait D
authors: TD
authors: Shanafelt
mesh_terms: D002055:Burnout, Professional / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D013502:General Surgery / Q000331:legislation & jurisprudence; D006801:Humans; D007588:Job Satisfaction; D016014:Linear Models; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D008875:Middle Aged; D010820:Physicians / Q000331:legislation & jurisprudence* / Q000523:psychology / Q000706:statistics & numerical data; D011331:Private Practice; D013043:Specialties, Surgical / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D000078329:Workforce; D016526:Workload