How Do You Survive a Game Where Even Winning Hurts?: Lessons from Lawsuits

In this episode, Dr. Vicki Rackner shares the lesson she's learned for her experience, being sued, serving as an expert in medical litigation and supporting physicians going through lawsuits. 

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Transcript

How Do You Survive a Game Where Even Winning Hurts?

Doctor, would you voluntarily play a game if you knew the rules said:

You always lose.

Of course not.

Yet physicians play that game every day.

Not because we choose to.

Because those are the rules when you're sued.

I learned that lesson after a three-year malpractice lawsuit.

I walked out of arbitration having prevailed.

There was no judgment.

There was no payment.

Legally, I had won.

Emotionally, it didn't feel that way.

There was no joy in Mudville.

My attorney saw it , and in an effort to validate may experience he said:

"Even when you win, you lose."

He was absolutely right.

Today I want to share some lessons I learned from being sued, from serving as a medical expert, and from helping other physicians navigate one of the most painful experiences in medicine.

If we haven't met, I'm Dr. Vicki Rackner.

I'm a retired surgeon and the founder of Thriving Doctors.

I've been sued twice.

I've served as a medical expert in malpractice cases.

And I've learned that the hardest part of a lawsuit is rarely the legal process.

It's what happens inside the physician going through it.

The first was my starter lawsuit.

I was a surgical resident.

My husband and I were eating dinner at our kitchen table when a car backed into our driveway.

The engine stayed running.

A man walked to the front door.

My husband answered.

The visitor asked for me.

Then he handed me an envelope and said:

"You've been served."

I took the envelope back to the kitchen table.

I opened it.

I had been sued.

Honestly, I didn't understand who was suing me or what I was being sued for.

Every medical student—and every surgical resident—knows that being sued is an occupational risk that comes with the territory.

Intellectually, I understood that it was possible.

But I had never imagined how completely a lawsuit could turn my life upside down.

I handed the papers to my husband.

As he read them, I watched his face change.

Then he looked up and said:

"It's not just you who's being sued.

The lawsuit names:

Vicki Rackner, MD and her marital community.”

My husband owned a business.

He had never signed up for the possibility that he could lose everything because he was married to a physician.

And suddenly, neither had I.

My mind immediately went to the worst-case scenario.

What if we lost?

What if we lost everything?

What would happen to his business?

What would happen to our future?

What would happen to us?

What if everything we've worked for is at risk?

A day or two later I was dismissed from the case.

That lawsuit introduced me to fear.

My second lawsuit was different.

I call this one my big-girl lawsuit.

I was no longer a resident.

I owned and ran my own practice.

The buck stopped with me.

There was no attending to turn to.

No institution standing between me and the claim.

The lawsuit lasted three years.

And that's the lawsuit that taught me the lessons I'm sharing today.

The first lesson is this:

Being sued does not mean you're a bad doctor.

I know that sounds obvious.

It wasn't obvious to me.

One of the first things many physicians do after being sued is start questioning themselves.

Did I miss something?

Was I careless?

Am I really as good as I thought I was?

As both a defendant and later a medical expert, I've learned something important.

Bad outcomes are not the same thing as malpractice.

Medicine is uncertain.

Complications happen.

Terrible outcomes occur despite excellent care.

Good doctors get sued.

Excellent doctors get sued.

Careful doctors get sued.

If you take only one thing from today's episode, let it be this:

Being sued is not proof that you're a bad doctor.

The second lesson is that patients don't always sue because they want money.

One of the most meaningful experiences I had as a medical expert involved a woman dying from gallbladder cancer.

She believed there had been a delay in diagnosis and wanted to sue her physicians.

I reviewed the records carefully.

I found no violation of the standard of care.

This was one of those heartbreaking situations where medicine had done its best and still failed to produce the outcome everyone wanted.

The attorney later told me that when she learned she didn't have a case, she was crestfallen.

That surprised me.

Why?

Because she said:

"Now I'll never have a chance to tell my story and learn from my doctors exactly what happened and why."

So I made an offer.

I would come meet with her.

I brought my anatomy book and my surgical atlas.

I listened to her story.

I answered her questions.

I explained what we knew and what we didn't know.

Most importantly, I listened.

At the end of our conversation she said:

"Thank you. Now I can die in peace."

That experience changed me.

Patients don't always sue because they want money.

Many want answers.

Many want understanding.

Many want acknowledgment.

Many simply want to be heard.

The third lesson is that secrecy breeds shame.

One of the most difficult aspects of litigation is isolation.

Physicians are often advised to be extremely careful about discussing the case.

The legal reasons are understandable.

But the emotional consequences can be profound.

After my lawsuit, I sought therapy.

My psychiatrist happened to have several physician patients who were also being sued.

She noticed something fascinating.

The secrecy surrounding litigation was creating shame.

Doctors were suffering alone.

Her solution was brilliant.

She created a consulting group.

We each paid one another one dollar.

One dollar.

Now we had a safe place to talk.

We weren't discussing legal strategy.

We were discussing the human experience of being sued.

We discovered we weren't alone.

I later named it The One Dollar Consulting Club.

One of the most important lessons I can share is this:

Don't do this alone.

The fourth lesson is about trust.

Before my lawsuit, I thought mostly about patients trusting doctors.

After my lawsuit, I realized doctors trust patients too.

We trust them to tell us the truth.

We trust them to partner with us.

We trust them to work toward the same goals.

The lawsuit felt like a betrayal.

Not just legally.

Relationally.

And it left me with two difficult questions.

How could I trust the next patient?

And perhaps even more importantly:

How could I trust myself enough to feel safe again?

For a while, I became more suspicious.

More guarded.

More aware of risk.

I don't think that's unusual.

Many physicians experience some version of that response.

The challenge is becoming wiser without becoming cynical.

Careful without becoming fearful.

Trusting without becoming naïve.

The fifth lesson is about boundaries.

Looking back, I can see that I contributed to the lawsuit.

Not because I violated the standard of care.

But because I failed to document an important phone call.

I was out of the office.

I didn't have a system.

Today I would handle that differently.

The lawsuit also taught me something about relationships.

When the patient first came to see me, he told me a story about how every physician had failed him.

As a young doctor, I remember thinking:

"This guy has had some really tough breaks."

Then I thought:

"I'll be the doctor who turns that around."

I remember thinking that.

Looking back, I wasn't hearing information.

I was hearing a mission.

The lawsuit taught me to pay attention to patterns.

It taught me that compassion and discernment can coexist.

You can care deeply about someone without taking responsibility for everything in their life.

You can help people without rescuing them.

And you can listen without ignoring information that's right in front of you.

Finally, treat yourself kindly.

A lawsuit is not a sprint.

It's a marathon.

Mine lasted three years.

Three years of uncertainty.

Three years of waiting.

Three years of wondering what would happen next.

Fear is normal.

Anger is normal.

Sadness is normal.

Shame is normal.

The goal isn't to avoid those feelings.

The goal is to move through them.

Before I close, I want to make one thing clear.

Everything I've shared today has focused on the emotional and human side of litigation.

That doesn't mean the practical side doesn't matter.

It does.

Physicians should work with qualified professionals to make sure they have appropriate malpractice coverage, disability coverage, liability protection, cybersecurity safeguards, and a thoughtful asset-protection strategy.

One of the biggest mistakes I see physicians make is assuming the only lawsuit they need to worry about is malpractice.

That's simply not true.

Sometimes the greatest risks come from places we never anticipated.

Take the case of a dermatologist I knew.

He was in his seventies.

He had already achieved financial security.

He wasn't working because he had to.

He was working because he loved medicine.

One day he sent an office employee out to pick up lunch for the staff.

While running that errand, she was involved in a motor vehicle accident.

The drivers of both vehicles were insured.

Most physicians would assume the matter would end there.

It didn't.

The family hired an attorney.

During discovery, the attorney learned that the employee had been acting on behalf of the medical practice.

Suddenly, the physician was pulled into the lawsuit.

The risk wasn't medical.

The risk was business-related.

And the consequences were devastating.

The physician who had continued working because he wanted to now found himself working because he had to.

The lesson isn't to live in fear.

The lesson is to recognize that malpractice is only one source of liability.

Sometimes the risks we fear are not the risks that ultimately threaten our financial security.

And that brings us back to where we started.

How do you survive a game where even winning hurts?

You remember that a lawsuit cannot determine your worth.

It cannot determine your character.

And it cannot determine whether you're a good doctor.

Only you get to decide that.

If you've been sued, I hope you'll remember this:

Good doctors get sued.

Good doctors suffer.

Good doctors recover.

And good doctors go on to build meaningful lives on the other side.

Because thriving isn't about avoiding life's hardest experiences.

It's about moving through them without losing yourself in the process.

Until next time, take good care of yourself.