Ep64 | The “Invisible Hand” Series – The Effect of Medical Malpractice on Health Care with Dr. St…

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Medical malpractice is often viewed as something that happens only inside a courtroom. But for physicians, its influence begins long before a lawsuit is ever filed.

In Part 1 of this conversation, Dr. Lee Sharma welcomes back Dr. Stephen Cohen to explore how the fear and reality of litigation quietly shape the practice of medicine. Drawing from more than three decades of surgical experience, including serving as both plaintiff and defense expert witness and personally navigating multiple malpractice lawsuits. Dr. Cohen offers an honest look at the emotional, professional, and systemic consequences physicians rarely discuss.

Together, they unpack how malpractice changes clinical decision-making, encourages defensive medicine, influences documentation, and affects physician confidence. Dr. Cohen explains why bad outcomes do not necessarily mean negligence, why hindsight bias distorts malpractice cases, and how litigation often leaves physicians carrying unnecessary shame despite practicing within the standard of care. The conversation also explores how the legal environment has improved certain aspects of healthcare. From stronger documentation practices and shared decision-making to informed consent and surgical safety checklists, Dr. Cohen explains how many of today’s patient safety standards were accelerated by lessons learned through litigation.

This episode is an insightful examination of one of medicine’s most influential, but least understood, forces, offering practical wisdom for physicians at every stage of their careers.

Episode Mentioned:

Episode 51 – The Invisible Hands on the Scalpel (https://podcasts.apple.com/us/podcast/ep51-the-invisible-hands-on-the-scalpel/id1812960559?i=1000765979955)

Three Actionable Takeaways:

• Bad outcomes are not the same as malpractice: Complications and unexpected outcomes occur even when physicians meet the highest standard of care. Understanding this distinction helps reduce unnecessary shame while promoting objective clinical reflection and continuous improvement.

• Excellent documentation is one of a physician’s greatest protections: Thoughtful documentation demonstrates clinical reasoning, informed consent, differential diagnosis, and shared decision-making. Good records protect both patients and physicians while improving continuity of care.

• Education creates safer physicians:Teaching residents and medical students how to think critically, communicate clearly, document thoroughly, and embrace surgical safety practices prepares them to become confident, independent clinicians capable of delivering better patient care.

About the Show:

 Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose.

About the Guest:

Dr. Stephen M. Cohen, MD, MBA, is Chief of General Surgery at the Veterans Administration Medical Center in Richmond, Virginia, and serves on the faculty of Virginia Commonwealth University. A nationally recognized colorectal surgeon, educator, and expert witness, Dr. Cohen has spent more than 30 years practicing surgery while also consulting on both plaintiff and defense medical malpractice cases. Through his educational work and public speaking, he advocates for better physician education, improved documentation, patient safety, and open conversations about the realities of medical litigation.

LinkedIn: Dr. Stephen M. Cohen, MD, MBA (https://www.linkedin.com/in/stephencohenmd?utm_source=share_via&utm_content=profile&utm_medium=member_android)

About the Host:

Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools.

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