PHYSICIAN HEALTH MATTERS

Taking Care of Yourself After an MIT

The day-to-day work life of most physicians is stressful enough, with patient-care responsibilities, time pressure, and administrative demands. But that stress magnifies if a physician is involved with a medically induced trauma (MIT) -- an unexpected adverse patient outcome due to a medical/surgical procedure, medical-system error, or other circumstances.

When an MIT occurs, physicians experience added stressors -- fear of possible malpractice litigation, pressure to practice defensive medicine, and intrusive third-party investigations -- all of which can negatively affect the patient-physician relationship. While the system understandably focuses attention and support on the MIT-affected patient and family, physicians must recognize this as a critical time to address their own emotional needs. Physician Health Services (PHS) encourages doctors and other providers experiencing the emotional impact of an MIT to reach out for peer support and reassurance.

After an MIT, physicians should consider bringing together the medical team and staff involved to debrief about the incident itself and about the emotional impact the event is having on the care providers. Full disclosure among parties at this crucial time will help create an organized and effective support system. Debriefing after such an event might entail scheduling a peer review or M&M meeting to help all involved deconstruct the MIT and assess its emotional impact.

Unfortunately, when the specter of malpractice litigation looms, physicians are often advised to remain silent about an MIT, which interferes with their ability to communicate in depth with the patient and medical team involved. While silence may be legally prudent, it can be counterproductive to a physician's well-being at a time when discussing the event will help. Chronic silence and isolation can lead to lapses in concentration, burnout, and the practice of defensive medicine.

When circumstances do not allow for a meeting of providers to discuss an MIT event, PHS can serve as a resource for support and consultation. We offer unique private consultative and support-group options in which physicians can share their experiences in a safe, confidential environment. Such sharing goes a long way toward alleviating the stress and shaken confidence that can interfere with a physician's ability to practice effective medicine.

In addition to seeking peer support, physicians should talk with supportive family members and friends. Most hospitals also have an employee assistance program or other confidential consultative support for physicians. Making the most of leisure time, recreational activities, and physical exercise can also help alleviate MIT-related stressors.

- Linda R. Bresnahan

To learn more about post-MIT support, contact Luis T. Sanchez, M.D., director of PHS, at (781) 434-7404 or visit www.physicianhealth.org. There is also a support group available specifically for physicians who are facing malpractice litigation; for more information, contact Michael Liebowitz, M.D., at (508) 862-5832. Also, for more information regarding MITs, visit the website of Medically Induced Trauma Support Services at www.mitss.org.

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