Malpractice lawsuits against surgeons occur often and can exact an immense toll, leading to depression, career burnout and other psychological distress, according to a new study.

The findings, published in the November 2011 Journal of the American College of Surgeons, found that stress arising from malpractice litigation was rated equivalent to that of financial woes, pressure to excel in research, conflicts between work and home, and dealing with patients' suffering and death. Surgeons who experienced a recent malpractice lawsuit reported lower career satisfaction and were less likely to recommend a surgical or medical profession to their children or others.

Hospitals can help by publicizing physician support programs, says Charles M. Balch, M.D., the study's lead author and a professor of surgery at the University of Texas Southwestern Medical Center in Dallas. Many practitioners are unaware that such programs exist, or they don't know how to access them. "It is so emotionally draining, regardless of whether the physician is at fault," Balch says.

Support groups can consist of department chiefs and other physicians who have been sued and walked in the same shoes as those who now need a shoulder to lean on. Professional associations also may suggest coping mechanisms. The American Academy of Orthopaedic Surgeons has 10 trained peer counselors who offer advice in these situations, says Douglas W. Lundy, M.D., chair of its medical liability committee and an orthopedic trauma surgeon in the Atlanta area.

Hospitals should not prejudge physicians named in malpractice litigation. "Unless the claim is meritorious on its face, or there is a potential danger to patients, the added stress of critical scrutiny by colleagues and peers can be the final straw for good physicians," says Louise B. Andrew, M.D., a litigation stress management and trial preparation consultant and former credentials committee chair at Johns Hopkins Bayview Medical Center in Baltimore.

Allowances also must be made for a relaxed and flexible work or call schedule during a malpractice trial. "No normal defendant would be kept up all night before an appearance at deposition or trial," Andrew says. "It would amount to torture."