The reasons medical malpractice is such a salient issue for physicians are poorly understood. In the 2006 ACOG Survey on Professional Liability 89.2% of respondents indicated they had one or more claims filed against them during their careers, with an average of 2.62 claims per physician. The literature and policy positions on professional liability tend to focus on monetary issues and litigation prevention, however data suggest that affective issues may be a central concern for physicians.

The objective of this study was to investigate obstetrician-gynecologists' affective, cognitive, and behavioral responses to the threat or reality of malpractice claims and litigation. These responses were explored through 15 in-depth semi-structured interviews with generalist obstetrician-gynecologists. Each participant also completed a questionnaire about demographics and claim history. A thematic analysis of the qualitative data was conducted using Interpretive Phenomenological Analysis.

Eleven of the fifteen (73.3%) physicians interviewed reported being named in one or more claims during their careers. Nearly all sued physicians experience emotional distress. For 80% of the participants the emotional threat of being sued was their top or one of their top concerns related to malpractice. Better support systems are needed to help physicians manage the stress of malpractice claims and litigation. A support group intervention that combines the support of colleagues with the expertise of a mental health professional would be ideal.

There is a disconnect between the focus of professional societies and the concerns of physicians. The financial reforms targeted by professional societies are unlikely to ease the emotional burden of malpractice on physicians. Other legislative and policy initiatives are needed to address these inherently psychological problems.