When Patients Pose Legal Risks: Recognizing Warning Signs in Healthcare

The practice of medicine is rewarding, but it is also fraught with challenges—one of the most difficult being patients who carry a track record of litigation. For physicians, encountering individuals who have previously sued other doctors can be unsettling, especially when those patients present with complicated medical concerns and a history of dissatisfaction with care.

A physician’s perspective

In an article published by MdLinx, Dr. Kristen Fuller shared how an encounter with one such patient left her feeling as though she was being interviewed for a job rather than providing medical care. She described becoming hyper-aware of every detail, knowing that any misstep could become the basis for a malpractice claim. Her story reflects a reality that many physicians quietly live with: the need to balance thorough care with self-protection.

The numbers confirm this widespread concern. A 2023 study by the American Medical Association (AMA) reported that nearly one in three doctors—31.2%—will face a malpractice lawsuit during their careers. While most cases never make it to trial, they still come with heavy costs, averaging around $30,000 in legal expenses, not to mention the stress and disruption to both professional and personal life. Importantly, the AMA stresses that lawsuits are not always rooted in negligence or poor performance.

Dr. Fuller herself had been named in a lawsuit that was later dismissed, but the experience altered how she approached her work. Like many colleagues, she found herself adopting elements of “defensive medicine”—ordering extra tests, being extra cautious, and documenting extensively—not just to protect patients, but also to protect herself.

Spotting the red flags

While not every difficult patient is destined to file a lawsuit, certain behaviors may indicate a higher risk. Physicians are encouraged to remain alert to patterns such as:

• Complicated medical histories – Patients with numerous conditions, multiple providers, and thick files of records may be searching for someone to blame when outcomes fall short.
• Refusal to follow medical advice – Consistently ignoring treatment recommendations can signal a higher chance of conflict later on.
• Criticism of prior providers – Negative remarks about previous doctors, including well-regarded ones, should prompt careful documentation.
• Persistent dissatisfaction – Constant complaints, whether about staff, wait times, or care decisions, can point to ongoing friction.
• Frequent “doctor shopping” or litigation history – Patients who move often from one provider to another, or who openly reference past lawsuits, present clear risk factors.
• Challenges to medical expertise – Those who arrive with stacks of internet research and aggressively contest professional recommendations need extra care, patience, and evidence-based communication

Balancing caution with compassion

Recognizing these warning signs is not about labeling patients as “bad” but about staying proactive. Careful documentation, clear communication, and professional empathy all go a long way in minimizing risk. At the same time, physicians must safeguard their own careers and peace of mind by ensuring they have  comprehensive malpractice insurance in place.

In an era where litigation is a near inevitability, the goal is to continue delivering compassionate care while also protecting oneself. Preparedness, vigilance, and coverage can help physicians navigate even the most challenging patient relationships with confidence.