This month we take a high level view of the landscape of 'tort reform' in the US (and what does that even mean?)

Physician-lawyer Dr. Shilpa Mathew, MD JD, walks us through some basics of tort law and advocacy efforts in the US, how you can get involved, and why it matters. (Note: Dr. Mathew's views expressed in this podcast are strictly her own, and not representative of her employer or ACOG.)

Shilpa Mathew, MD, JD, is a Northern California physician double board-certified in Obstetrics & Gynecology and Lifestyle Medicine. She is a former practicing attorney who spent the latter half of her legal career focused on health insurance and regulatory compliance and brings a unique perspective to the intersection of law, medicine, and policy. She has long been active in health advocacy and policy efforts—ranging from things such as pro bono legal work to protect basic health rights of foreign detainees in US prisons to serving as a medical student delegate to the California and American Medical Associations. She has a particular passion for issues related to medical malpractice and focused her residency research project on malpractice knowledge, attitudes and perceptions of OB/GYN residents nationwide. Currently, she serves as the Co-Chair of the Legislative Committee for the American College of Obstetricians and Gynecologists in California, where together with a team, she helps shape policy to advance women’s health.

BONUS: In the introduction, host Dr. Gita Pensa talks about her own litigation advocacy wish list - there are some 'standard' wishes on there, and some you may not have considered before.

Here is Dr. Pensa's informal Holiday Wish List for malpractice litigation reform.

• Similar to Utah HB 503 legislation: if doctors carry adequate liability coverage, no going after their personal assets
• Or at least abolish post-judgment wage garnishment, or have limits on duration
• Very clear and consistent protections of retirement accounts and primary residence
• No punitive damages demands without case passing a strict standard/tribunal beforehand
• Protection for mental health records and peer support/emotional support for health care workers
• No data bank reporting in no-fault settlements
• Employed doctors can't be named as individuals (think about other corporate litigation -- Boeing, for example. Engineers aren't named individually)
• Employed physicians should get "litigation leave", time for litigation prep and trial, and no adverse consequences if productivity-based

• Caps on plaintiff's attorney contingency fees, and no double dipping for costs above that
• "Loser pays" ("English rule") for legal fees
• Attorney should face consequences for baseless punitive damages accusations
• Limits on venue shopping
• Limits on pre-trial or pre-resolution publicity
• Prohibition of attorney social media posting about active cases, especially disparagement of involved parties
• Sanctions for misleading press pre-trial press releases (which can cause reputational harm for doctors)
• Standards of professionalism for depositions and reasonable limits (6h) for duration (and consequences for not adhering to them)

• Require Michigan Model-type early resolution attempts, and require the doctor and plaintiffs to be in the room together
• Early neutral evaluation (with currently practicing, same-specialty physician input), with ability for outright dismissal for reasonable care
• Time limits on expert retention -- no plaintiff's expert supporting the case a year after filing? No case.

• No testifying if you are not currently actively practicing and in same specialty as defendant
• Medical board oversight of expert witnesses -- with the ability to censure
• Legal implications for outright false testimony

It's a wish list. But...the only way to move towards any of these steps is through involvement and advocacy.

Happy Holidays to all, and we'll see you in 2026.

REMEMBER: Use code LEAP100 until December 1st, 2025, to get 100$ off of the LEAP for Clinicians course! Eligible for 16 Category 1 CME/CNE Credits. Learn the essential mindset and skillset you need as a clinician in litigation, all in one place.

This month: finger pointing among health care professionals after an adverse event, or during litigation.

We've all seen it: the tertiary care center dumping on the community hospital in their notes. The specialist criticizes the primary care doctor or the ER's management. The doctor blames the nurse. The nurse charts defensively, ending with "MD Aware." The attending blames the resident. The resident blames the attending! All in a chart war, preserved for perpetuity.

Or even more sinister: a surgeon, after an adverse surgical event, tells the family the awful news -- and then tries to implicate someone else: the anesthesiologist, the CRNA, the radiologist who read the study...

You know we could go on. We've all seen it.

And then, once litigation starts -- now we're co-defendants. How does this 'blame game' play for a jury?

Is the chart the place for these disagreements? (Spoiler alert: NO.) Can finger pointing in charting actually backfire and get you pulled INTO a case? (Spoiler alert: YES.)

Our guest today is Heather Hansen, trial consultant and communications expert. For over 20 years, she defended providers and hospitals in medical malpractice cases. She created a curriculum for medical residents, teaching them communication and advocacy tools. She has helped leaders from Harvard Business School, Google, LinkedIn, LVMH, the American Medical Association, and Hospital Corporations of America advocate for change, resources, opportunities, and attention.

Welcome to Season 3 of Doctors and Litigation: The L Word!

We start off with an update on the LEAP Course (Litigation Education and Performance) -- sign up from now through December 1, 2025 with coupon code LEAP100 and get $100 off. Now with up to 16 hours of Category 1 AMA CME Credits!

https://www.doctorsandlitigation.com/LEAP/signup

Our first conversation in Season 3 is with Dr. Anthony Orsini of The Orsini Way.

Communication with patients or families after unexpected medical events is crucial, but most of us have no formal training in how to do it well. Compassionate and skilled conversations can pave the way for understanding and closure for families. However, when handled poorly or defensively, these conversations can create resentment, distrust, and anger, which can also make litigation more likely.

What do patients and families want from us in these moments? What do we do with our body language? What happens if we cry? Can we show compassion by touch, on the hand or the shoulder? Why is this so difficult? Have we lost our humanity in the name of professionalism?

Dr. Orsini has spent the last 25 years developing proven communication techniques that help doctors build rapport and quickly form trusting relationships with their patients. Come along as we discuss evidence based strategies to handling these conversations better.