New podcast on KevinMD: Using inquiry-based stress reduction to treat medical malpractice stress syndrome

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or read the article here

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Putting Stressful Thoughts on trial
A Live One-on-One Zoom Course to Thrive during Malpractice.
6 Category 1 AMA credits

We have worked exceptionally hard, jumped through countless hoops, missed family events, and dropped friends and hobbies to be doctors. It is one of the world's most stressful jobs, and we have the depression and suicide rates to show it. And then, one day, we receive the dreaded envelope informing us that we are named in a malpractice lawsuit. Allegedly, our incompetence has caused suffering to a patient. This simple subpoena initiates, for most of us, one of the most stressful events in our lives, similar in intensity to divorce, illness, or the death of a loved one. 

Medical Malpractice Stress Syndrome

The stressed mind floods us with limitless variations on "I will lose everything, I am not a good doctor, the world is unfair".  We become anxious, angry, and absent, sometimes becoming completely incapacitated. Out of shame, we withdraw from our colleagues and friends, feel physically ill, and may even want to leave our jobs. This phenomenon is so common and debilitating it has been named "Medical Malpractice Stress Syndrome"

Our lawyers then advise us to show up as "likable", as juries deem this an important factor when issuing a verdict. How can we be agreeable when we are filled with stress, anger, and uncertainty?   

If you are distressed by anything external, the pain is not due to the thing itself but to your own estimate of it; and this you have the power to revoke at any moment." —Marcus Aurelius

 

This quote points to the key to surviving and even thriving during a lawsuit. Aurelius would explain the lawsuit isn't intrinsically stressful, but our thoughts about it make us stressed. Malpractice cases show us where we have unexamined assumptions about ourselves. Thoughts such as: "I can't make a mistake, people are judging me, I am only as good as a worse outcome" is at the root of our unhappiness. Opposing counsels leverage our unquestioned beliefs to their advantage. Despite the fact that most physicians prevail in court, lawyers see great opportunity in suing us as they know that the shame of our unquestioned beliefs will drive us to settle a lawsuit in their favor.  

The good news is that since our stress is based on our assumptions, we can change our perceptions and see our situations more clearly if we are willing to question the unexamined thoughts that drive our stress. 

Inquiry-Based Stress Reduction (IBSR)

Self Inquiry (or Inquiry-Based Stress Reduction, IBSR) is a method of addressing the stressful beliefs that emotionally highjack us. It posits that we are unable to let go of our stressful thoughts because we haven't inquired into their validity. As long as we believe everything we think, we will stay caught up in stress. 

Inquiry puts our stressful thoughts through a series of penetrating questions, much like a lawyer who cross-examines a witness. These questions allow us to see the situation in a wiser, kinder way. Post inquiry, these thoughts no longer plague us. IBSR liberates our minds of these stressful thoughts to be more effective, focussed, and present. 

Mindfulness-Based Stress Reduction (MBSR) 

MBSR has been shown in countless clinical trials to reduce stress, improve immunity and reduce chronic illness. During the course, you will be initiated into this practice which is the basis for ongoing stress reduction. We will also practice breathwork, gratitude, and self-compassion practices. We will look critically at other lifestyle habits such as media use, diet, and exercise. 

Learning Objectives:
  • Learn and practice IBSR and MBSR 

  • Understand the neuroscience of stress

  • Institute daily practices for lifelong wellbeing

  • Improve performance in depositions and in court 

  • Improve resilience 

What is included

  • Six 60-75 minute one-on-one confidential IBSR/MBSR video sessions, scheduled at your convenience

  • Accountability check-ins 3-4 times a week by text/phone

  • Weekly reading and video material

  • Guided meditations

  • Availability to schedule PRN sessions (ex: before depositions) or emergent sessions as schedules allow

  • Access to 90-minute "office hours" twice a month for group meditation and inquiry ​

Cost: 2875$

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Teaching experience

I have been instructing well-being practices for over 15 years, beginning at Kirtland Air Force Base and helping airmen deployed to Iraq and Afghanistan work through combat stress. A speaker for Vistage International, The Executive Company (TEC), and an expert in the neuroscience of well-being, I give workshops throughout the US and Canada, helping physicians and entrepreneurs understand their minds. I have used IBSR and MBSR to help me through my own lawsuits as well as the other challenges of being a doctor, wife, mother, business owner, and non-profit executive director. 

Week  1

The stress response  - How the mind reacts under stress.

   Fight or Flight

   The default mode

Inquiry: the basics of questioning stressful thoughts

Healthy Habits: Morning and evening routines 

Week 2  

Introduction to  Mindfulness

   Benefits of Meditation

   How to meditate

Inquiry: recognizing who and what triggers you

Healthy habits: Meditation

Week 3 
Get to know your Saboteurs
    How do you show up when stressed? 
     Review of the ten saboteurs
Inquiry: Are your thoughts accurate?
Healthy habits: Exercise
Week 4
Understand your strengths 
    The Sage mind
Inquiry: How do your beliefs affect your mood?
Healthy habits: Gratitude
Week 5
Personal vs Impersonal Mind
   Neuroscience of flow states
   No self, no problem: new understandings of wellness
Inquiry: going deeper into inquiry
Healthy Habits: Breathwork 
Week 6
Left/right Brain differences
   The left brain interpreter
   Right brain dominant systems
Inquiry: Living turnarounds
Healthy Habits: Self Compassion

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the New Mexico Medical Society (NMMS) through the joint providership of Rehoboth McKinley Christian Health Care Services (RMCHCS) and (name of program sponsor). RMCHCS is accredited by NMMS to provide continuing medical education for physicians.RMCHCS designates this live activity for a maximum of 6 AMA PRA Category 1 Credit(s)™. Each physician should claim only the credit commensurate with the extent of their participation in the activity.

To enroll please email larapatriquin@gmail.com or call (505) 269-4097
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Marie Wagner Brown, MD
Pediatric ENT Surgeon

Working with Lara changed my life. Her understanding of the mind and piercing questions pull the rug from under my stress and unhappiness. I wish I'd had these insights earlier in my career!

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Katie Lopez, MD
Radiologist

Lara was my lifeline during my lawsuit. She kept me accountable for healthy habits which I still practice! Through her mindset change exercises, I was able to use the malpractice experience to become happier and healthier. 

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Jose Avitia, MD
Medical Oncologist

Lara's wisdom and insights have helped me navigate the stress of my busy practice. I always see things differently after talking to her.