A Candid Discussion With Dr. Fortner About Physician Burnout, Litigation & More!
By: Dr. Tomi Mitchell
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In this episode, I, your host, Dr. Tomi Mitchell, had the pleasure of interviewing the lovely Laura Fortner
About our Guest
Dr. Fortner is an OBGYN Hospitalist, Speaker, and Coach. She has turned her pain into purpose. She herself was sued and went through all the emotions of anger, fear, shame, and helplessness. Through her journey of healing the Med, Mal Coach was born.
She now is an expert in litigation stress and she helps physicians thrive through medical malpractice.
Transcript
Dr. Tomi Mitchell 0:07
Hello everyone, this is your host Dr. Tomi Mitchell from the mental health and wellness Show. Today I have the pleasure of introducing Dr. Laura Fortner. She is an OBGYN, hospitalist, speaker and coach. She has turned her pain into purpose. She herself was sued and went through all emotions of anger, fear, shame and helplessness through her journey of healing. The med mal coach was born. She is now an expert in litigation stress, and she helps physicians thrive medical malpractice. With no further ado, Dr. Laura, thank you to the show. Thank you for coming.
Dr. Laura Fortner 0:42
Yeah, thank you so much for having me.
Dr. Tomi Mitchell 0:44
Oh, it is honestly my pleasure. I applaud you for stepping up to the plate to talk about this very personal experience that as physicians and you know, anyone else who's gone through a situation that they're not proud of, it's hard to talk about sometimes, and it's painful. It's not it threatens your sense of value like your worst like really like why you know, but I guess with these this profession call medicine we have to embrace the good bad and the ugly that can come with it and OBGYN are unfortunately up there when it comes to dealing with this kind of stress.
Dr. Laura Fortner 1:20
Yeah, so it's funny because I think you know, being in the medical profession, you know, as you do your training and your residency and all that and you get out you do feel infallible like you feel like you know, you know what you're doing you're good communicator, that won't happen to me. And the statistics are it's actually normal. So getting sued for medical malpractice and high risk specialties like the surgical fields, OBGYN, even ER, if you practice till you're 65, 99% of us will be named in a lawsuit and those in low risk specialties it's 75%. So it's, it's the norm, but the funny thing is, is we walk around and shame thinking it shouldn't have happened to us. And and I think some of it is because of stocks, we mix up who we are with what we do.
Dr. Tomi Mitchell 2:11
Our MD is like your identity that's like it's defines you and what society thinks that MD means and what your colleagues and yourself but your patients.
Dr. Laura Fortner 2:21
Yeah, for sure. And so I think that mixing up because, you know, other professions get sued, right? Like for malpractice, I mean, lawyers and insurance companies and corporate execs, like they get sued but they understand that it's business and like they can separate that out but for us who've spent our whole lives in medicine, sacrificing actually sacrificing at the expense of our family, really I mean, because look all the events that we miss from first steps of our babies to you know, soccer games, sporting events, family events, all that stuff, we miss putting patients first and when something like this happens, it's it's shakes us it really. It's it's a moral injury to us.
Dr. Tomi Mitchell 3:04
Yes, you you've nailed it. I love the term moral injury, right? Because we we have these high ethics and the sense of sacrifice and duty. And like you said, during that process, this long journey of becoming a physician and being a physician, because it doesn't just end when you get board certified. It's like a continuous process of staying up to date, date or certifications, etc, etc. Um, we do miss out on things. We're expected to miss out on things.
Dr. Laura Fortner 3:31
Yeah, I think that's what the key is, we are expected all the way are these the extreme beings of having to do something and we'll say we're fine. But when we're when we're really not, you know, because that's what we're expected to be we're expected to be this person. And I think we have this culture of perfectionism that is embedded in everything that we do. And so it really causes us harm and suffering when something like this happens because we can't reconcile, gosh, you know, was there a mistake? You know, if and if there was, that's normal, right? Like Mistakes happen, complications happen in anything that we do.
Dr. Tomi Mitchell 4:10
Yes, good things happen to good people that they're part of it but we don't embrace that and accept that physicians and I and I know many of them professionals, but because we have both physicians, we know how hard it is to get into medical school that into residency, stay in there, get through it get through boards, it's hard. So we're already a subset of society who are a little neurotic little perfectionism somewhat right type a pardon ourselves, and then who human beings trying to embrace this like Superman, Superwoman suit or invincible though we're supposed to be all for everything because that's what we've said we will do. But the crazy thing called life there are things that are outside of our control, outside our control.
Dr. Laura Fortner 4:56
Yeah. And that's the thing. It's like, you can follow this standard of care to a tee and most of us do.
Dr. Tomi Mitchell 5:03
Yes.
Dr. Laura Fortner 5:03
But bad outcomes occur. And that's why I love to speak on. My title is like good. Doc's get sued. Because this again, is a lot of times out of our control, we can do all the preventative stuff that we know. And I have a whole thing where that I talk about avoiding litigation, but at the end of the day, it's not in our hands, whether somebody sue's us or not. And it's really what they decide. And so all we can do can do is control our response, and really being able to learn how to heal through the process. Because what happens in our culture is it's so taboo to talk about, right? We're not supposed to talk about it, I was just saying how I came out and just like publicly told people on social media that I got sued for medical malpractice I'm and I think I'm the only one doing it like anybody else doing that right now. But, but I think just just being that person and being the decision advocate, because that's really what I like I am because this tablism of talking about it actually perpetuates the problem.
Dr. Tomi Mitchell 5:03
Yes.
Dr. Laura Fortner 5:10
Cuz does not able to heal from something like this.
Dr. Tomi Mitchell 5:25
100%. And you know, I'm just looking at the time of this recording, because I don't typically release the same time I recorded I literally, it was International Women's Day 2022 I have the courage to post a letter to my clinic that I had in my heart for years. And that was basically I reached my breaking point, I need time to heal from the trauma. And to be the human I need to be the wife and the mother I need to be, right? I mean, like you said, it's scary coming out, especially when it gets attention, good, bad and ugly. But most people feel that they don't actually help us see it, but it takes lady balls. Okay, ball speeds to be able to like I am doing this not just for myself, but also to help the future doctors coming up.
Dr. Laura Fortner 6:58
Yeah, that's really what I want to do. I want to be that advocate for them. Our system is breaking and doctrina that I know all too well. I mean, I my lawsuits gone on almost a decade. And it's been insane from dismissal to get reinstated to trial to appeal after appeal. And so it's a long process. And the system, quite frankly, is can be improved.
Dr. Tomi Mitchell 7:25
Woah, 100%.
Dr. Laura Fortner 7:28
Yes. And the thing is, is we're talking about a body of people right now that I think are on the brink medical professionals in general on the brink due to the pandemic and all the things of this burnout and you need to heal themselves because they have put this medical profession on a pedestal and it's been first first first for everything and they've done what is expected of them at the cost.
Dr. Tomi Mitchell 7:52
Yeah.
Dr. Laura Fortner 7:52
Of themselves.
Dr. Tomi Mitchell 7:53
I agree.
Dr. Laura Fortner 7:54
And the trauma. And so you talk about trauma, and this is something that it when you get sued in medical malpractice is actually like PTSD. And you can go from litigation stress to medical malpractice stress disorder, which is in the DSM. So it's it's an entity that is real. Dr. Sarah Charles, a psychiatrist had done all this research way back in the 90s. About this and how the trauma that induced in physicians, and physicians couldn't talk about it. So there was no healing going on. So it is a big thing. And kudos to you.
Dr. Tomi Mitchell 7:54
Thank you.
Dr. Laura Fortner 7:56
For doing that for yourself.
Dr. Tomi Mitchell 8:02
And you know what, you mentioned a really good point that hit home and I'm going to say it because I'm an open book. Like, I've never been sued. However, I've been the physician who's had like college, you know, improve like, I think what was it, I failed to respond in a timely manner about prescribing. And because of that, I was charged with unprofessionalism, and then where I practiced, everything hits the fan, everyone knows, but the fact is, I was dealing with my own OBGYN complications at that time, like preterm labor at 20 weeks of pregnancy, you know, just like drowning in personal things, plus, being an owner of a clinic plus being expected to be at this high standard, regardless of what was going on in my life. And you're right, that did cause some PTSD, trauma. Right?
Dr. Laura Fortner 9:16
Yeah. And yeah, and I think the thing is, is, you know, just that that wording in that language that shows you is, you know, it's like, we have to be this perfectionistic person. And the bottom line is we're human, we are human, we are human beings practicing, we're doing the very best that we can with all of the medicine that we have. We do the research, we know what we're doing. And you know, what's funny, too, is with these cases, and even in you know what happened with you like most of the time, if we could sit back and look at both perspectives, and have a better way of approaching each other.
Dr. Tomi Mitchell 9:55
Yes.
Dr. Laura Fortner 9:56
From the lens of trying to sit in that other person's shoes. We could go so much farther as a population in humans in general, and in the medical profession. And so, you know, I know some of this is, you know, people talk about mediation and all those kinds of things. And that's the formal term, but I'm just saying, like, you know, we're real people at the end of the day on both ends. And what happen is we get objectified, you know. Yeah.
Dr. Tomi Mitchell 10:22
It's it's really sad and you mentioned wording, right? And then the connotation and, and not realizing the impact the situation has on both people, not not only those the plaintiff or whoever, but the defendant.
Dr. Laura Fortner 10:36
Yes.
Dr. Tomi Mitchell 10:36
Right?
Dr. Laura Fortner 10:37
Yeah, yes.
Dr. Tomi Mitchell 10:38
Sentimental, emotional impact. In some cases, you're left hanging literally, like you're, you're just, you know, like, you're beaten up.
Dr. Laura Fortner 10:46
Yeah.
Dr. Tomi Mitchell 10:46
And then they say, but while you're being beat up, continue being on top of your game. 24/7. Literally.
Dr. Laura Fortner 10:53
Yes. It's so funny. You say this, because the American Medical Association actually came out with a statement saying the biggest harm to litigation was emotional injury of the defendant. And same with this, the same scenario. I mean, I know you weren't sued, but like, it's the same sort of connotation. And when we get served papers, I had a sheriff come to my door, like a couple days after the holidays with my kid answering the door serving me papers, because they plaintiff's attorneys like to do those kinds of things. And you know, when I was served, and you start reading it, the language is just
Dr. Tomi Mitchell 11:30
Yeah.
Dr. Laura Fortner 11:31
Feels like you. You have.
Dr. Tomi Mitchell 11:33
Done something horrible deliberately.
Dr. Laura Fortner 11:35
Yeah.
Dr. Tomi Mitchell 11:37
Right?
Dr. Laura Fortner 11:37
Yes, yeah, yeah.
Dr. Tomi Mitchell 11:39
Definitely, I completely. I completely hear. For me. It came when I was like, I think I was in emergency induction of my labor when I got the letter. And I was just like, fine. Sure. A sign? Yeah, sure. Okay.
Dr. Laura Fortner 11:53
Wow.
Dr. Tomi Mitchell 11:54
You know, it's like.
Dr. Laura Fortner 11:55
Yeah, and I like to say this, because maybe some physicians can identify with what we're talking about right now. And they're listening to this. And, you know, they've been through something like you, or maybe something like me and been sued. And one of the things one of the easiest things they can do right away is they could think about if this were happening to a really good friend, colleague, right now, if this were happening to that good friend, write down exactly what you would say to that friend, and then say it to yourself, and start learning some self compassion. Because normal, what happens with us? I mean, these things happen, they happen. And it doesn't mean that we're bad physicians,
Dr. Tomi Mitchell 12:35
Yes.
Dr. Laura Fortner 12:35
But we want to we make it mean something, right?
Dr. Tomi Mitchell 12:38
100%. And speaking of bad physicians, I sometimes feel that it's in that pursuit of being of excellence of China go above and beyond and showing some of your humanity is when you open yourself up to vulnerability.
Dr. Laura Fortner 12:54
Yeah.
Dr. Tomi Mitchell 12:55
As a human.
Dr. Laura Fortner 12:56
So true.
Dr. Tomi Mitchell 12:56
Right?
Dr. Laura Fortner 12:57
Yeah.
Dr. Tomi Mitchell 12:58
I'm proud of you for opening up and sharing this because you are not alone. I know. In my case, when I opened up the mic came to me saying, I've done my practice, basically, like my little town where I live, it's like, every news person got a hold of me, it like has stirred up a lot of stuff. But I mean, we needed to talk about burnout, frustration, the the imbalance, like humanity, and what is happening to this profession that we both love when we both been in for over a decade. Right?
Dr. Laura Fortner 13:28
Right, right. And if we don't do this, now, this profession is not going to stand I mean this, there's, people are leaving in droves right now, a lot of physicians are deciding, I'm just going to retire early, or I'm just going to be done with this part of practice. Or I'm, you know, because of what's happening, and you know, who's going to take, I guess, from from my point of view, or the physicians point of view is like, who's gonna take care of you got, you know, like that population? If we, it's got to be a two way street? In some sense.
Dr. Tomi Mitchell 14:02
I agree. Because we need them just like they need us. Right?
Dr. Laura Fortner 14:06
Yeah.
Dr. Tomi Mitchell 14:06
I mean, we continue to have children and questions with their reproductive organ. Right?
Dr. Laura Fortner 14:12
Right. Totally. And there's, you know, things happen and they need to see us for things so it's, it's really good to just kind of really learn each other's perspectives and then be able to maybe come together I think one of the biggest downfalls especially when COVID hit and start this isolation and not being connected has really taken a toll and this is exactly what happens with things that you know, something like that that happened to you and and getting sued you know, we're I'm walking around in the hospital, not supposed to say anything, because that's what we're told. And by a friend over here has the same thing going on with her and she's not supposed to tell me right and so which is ludicrous, actually what they should be saying instead of saying, you can't tell talk about it. What they should say is you can't talk about the chart or the details. But you can talk about how you're feeling emotionally how it affect us, and go get help. And that's, I mean because if we have.
Dr. Tomi Mitchell 15:11
Go get help, what do you mean sounds so funny. We can help? You mean talk to a shrink so you're crazy. What? Are you able to practice? Your temperature? Are you okay?
Dr. Laura Fortner 15:22
It's so true. It's exactly true. Because this this, my whole point is we tell our patients to go get help when they need help through emotional stuff. And then we don't follow our same advice. And a lot of that is because and we can go on about this, but those questions on hospital privilege applications, treated anyway or seen a therapist. Is that not a HIPAA violation, right?
Dr. Tomi Mitchell 15:46
Thank you and this is what I say about that. I said, everyone, as long as you have a heart and a brain, you're gonna have some mental health concern at some point, and we all should be seeing a therapist at some point, it should be like, you know, you know, Q2, monthly, whatever, PRN. And then obviously, at the set of cages, like it should just be standard for everyone. And we should stop this taboo because this is this is this whole taboo and secrecy and punitive mentality is what is hurting us and besides it physicians have the number one highest rate of suicide like Hello, there's a reason. There many reason, but there's part of life.
Dr. Laura Fortner 16:22
Yeah, which is so funny, they actually I just posted this, they polled and certain practices or specialties had higher rates of suicide, you know, and suicidal ideation. And there's no data on this. But I can imagine that, especially with the times right now getting slapped with a medical malpractice lawsuit on top of everything else, I I'm sure that that increases your risk of suicide, I am sure.
Dr. Tomi Mitchell 16:27
100%
Dr. Laura Fortner 16:36
That there is you know, and I do know of stories of physicians who got sued, and then it was all over the news and all these things, and they, they just ended their life. And it's not. These things shouldn't be taken lightly. And there is ways to improve this for sure. And I think it's one of the things that needs to be looked at. And this is one of the things why I'm so proud of like, I'm going to be that physician advocate, I actually have created a Facebook community for those that care about medical malpractice and want to be in the know and the updates, as well as also how to get through it. And it's it's just a free resource. And that's awesome. So if somebody wants to be a part of that, it's called we rise in the face of medical malpractice, they can go search for that group. And if they're a physician, they can come in.
Dr. Tomi Mitchell 17:32
100%, that's awesome. We'r