Transcript

Dr. Gita Pensa: [00:00:00] Knock,

knock,

Will: hi! Knock, knock, hi!

Hello and welcome to Knock, Knock, Hi! with the Glockenflecken. You startled me. I came in hot. I came in hot on that one. You sure did. I am Will Flannery, also known as Dr. Glockenflecken. 

Kristin: I’m Kristen Flannery, also known as Lady Glockenflecken. You 

Will: know I was, I’m excited about this episode. Usually 

Kristin: you like take a beat or two, you know, I was waiting for 

Will: that.

No, I’m just, I’m going right, right into it. You’ve had your coffee. We, so before we, you know, one thing that’s been on my mind is, is just one, just one thing, one neuron, just a little firing this morning. Um, and I was remarking with the producers before, uh, you, well, as you were getting ready for the podcast.

I, of course, sat down and, uh, got here a few minutes early. Well, hold on. You 

Kristin: know I wasn’t getting ready [00:01:00] for the podcast, right? I was already ready. Okay. I’m doing things around the house and with my work. 

Will: I’m not, I’m not criticizing you. What I’m, what I’m saying is that I find it, uh, impressive that you can just Come in to our little studio here, sit down with like 20 seconds before we have to go live with a guest, and you’re just ready to go.

Like, I need to sit down, I need to like, like get my mind right, and like, I need like 5 minutes. Well, 

Kristin: my, my neurons fire faster than yours, 

Will: that’s all. You’re like 20 seconds, I’m good, I’m good. I got what I need. I was just putting a load of laundry in. I was, I was washing the kids sheets. And then you come in, sit down, bam, we’re 

Kristin: going.

Yep, because I’ve already thought about it. I’ve already prepared. I’m good to go. Also, I work better under pressure 

Will: I have realized that with you. Yeah, you you tend to wait a little bit on 

Kristin: [00:02:00] things Apply I’ll create some pressure and then I then I’m 

Will: But, uh, yeah, I came in hot because, uh, we have a guest that’s, it’s a very exciting guest, uh, that is a little bit off the beaten path for, uh, as a topic, something we haven’t touched on yet.

Yes. But very important. Very important. We’re talking to Gita Pensa. MD, she’s an adjunct associate professor of emergency medicine at Brown University and a physician at Brown, uh, University Health and Wellness. And she has a fascinating story, um, uh, regarding litigation. So she is a, she speaks nationally on the topic of malpractice litigation and litigation stress.

Uh, she has, uh, uh, uh, she’s been at like trial twice, like a, like 12 years of her life was, was taken up by a malpractice case. Uh, so she talks a lot about that during our conversation. Uh, she has an open access podcast curriculum. Which is [00:03:00] a podcast curriculum. Yeah, it’s a cool idea. Like you can you can listen to this podcast and learn so much about Litigation 

Kristin: so it’s called have been assigned her podcast curriculum in their 

Will: Yes, so the podcast curriculum is called doctors and litigation the L word and basically just she just does an incredible job of shining light on this this topic that We don’t get any med, any education on as physicians.

Uh, and so it’s this black box and, and it doesn’t, it shouldn’t be, we need, we need more education about this stuff. So we talk about all of this, uh, fascinating stories, just a whole different world than, than I’ve, we’ve ever been in. I, I, I mentioned later on that I, I did serve on a, like a one day jury, but that’s as far close as I ever got to the, the justice system.

Kristin: I got called in for jury duty once and I had to spend a few hours. there, but then they didn’t end up needing us and they just let us all go home before we did anything. So, [00:04:00] it was just a way to miss work for a morning and get to read a book. 

Will: There you go. Obviously, we have a lot to learn during this interview, so let’s get to it.

All right? Let’s go. Here’s Dr. Pinsa.

Today’s episode is brought to you by the Nuance Dragon Ambient Experience or DAX for short. This is AI powered ambient technology that helps physicians be more efficient and reduce clinical documentation burden that we all know causes a ton of burnout, takes up so much time. Makes you feel overwhelmed.

Well, DAX is here to help. To learn more about how DAX can help you reduce burnout and restore the joy of practicing medicine. Stick around after the episode or visit nuance. com slash discover DAX. That’s N U A N C E. com slash discover D A X. Do you want to tell them or should I? You can. All right. We’re telling our amazing story live [00:05:00] in person.

Oh, you mean the story where you died? Uh, no. The one where you survived me dying. Oh yeah, right. We can’t wait. We’re going to be a meet and greet before each show. Uh, you can get a photo with us. You can meet us. We want to meet you December 9th, 10th, and 11th in Southern California. We’ll be at The 

Kristin: Improv in Irvine, Ontario, and Oxnard.

Will: To buy tickets and check out the dates, go to glockenflucken. com slash live. And we have a special offer for our Patreon members, the Glock Flock. Free meet and greet with a normal ticket. Just tell us your username and you’re in. See 

Kristin: you in Southern California.

Will: All right, we are here with Dr. Pensa. Thank you for joining us. We’re so excited to talk with 

Dr. Gita Pensa: you. Uh, I don’t have, I don’t have, no, if you have any idea how excited I am to be talking to you. Uh, I am a huge, huge, huge fan of, and an admirer of all that you do. I enjoy the content, um, I’m just, I’m such a huge super fan, so.

And [00:06:00] everything that 

Kristin: he does as well, right? That’s right. Yes. 

Dr. Gita Pensa: Both of you, in your own rights, I enjoy and admire. 

Will: You didn’t bring, you didn’t wear your emergency, your, your bicycle helmet, that, and that’s fine. That’s okay. Um, we’ll, we’ll be able to, to keep going. But you, you have some fans as well because we were, several people reached out and said that we should have you on this podcast.

Oh, that And, and then hearing, Um, Hearing about your, your bio, everything that you’ve gone through and what you do, it’s, it’s, uh, definitely like, uh, we’re excited about this, but before we get into it, I thought I’d, I’d kind of try to explain to Kristen why this topic is so interesting to physicians. Okay.

So we’re going to talk about malpractice a lot today, um, and like litigation and stuff. You know, how. So I like, Geeta, I like scary movies. Big horror movie fan. And Kristen is like, she’s always like, I don’t understand why. Like, why do you like to watch this? Like, horrible [00:07:00] things happening. Uh, what’s the, what’s the appeal about this?

And there’s something about like, watching a scary movie and it’s like, Like, what if this happened to me, kind of thing, like, what, what, what would I do? That’s 

Kristin: exactly why I don’t 

Will: like to watch them. It’s like a morbid curiosity. Well, it’s almost exactly the same with listening to 

Dr. Gita Pensa: stories about malpractice.

Well, you were running away. I know you wouldn’t trip while you were running away, and you wouldn’t go in the room that you weren’t supposed to go in. Right. Don’t leave the house 

Kristin: alone. Yeah. Right, 

Will: right. All the things. Right. And so, uh, and so it’s, it’s very, I feel like listening to people talk about malpractice and litigation and, and these, these, these, these sometimes horrifying, terrifying stories is it’s kind of.

A similar feeling like to, to watching a horror movie and like, Oh my gosh, what if that happened to me? What, what would I do in that situation? Oh, it’s, it’s just has a, has a similar vibe to me. And so [00:08:00] that’s why I am so curious about what you have to say and, and, and I want to hear all about what you do.

And so, um, so thank you for being here and, uh, you know, thank you for listening. for providing like a little horror show, horror movie for 

Kristin: us here. This is, this is how we all know that you don’t have anxiety and I do because my own mind is a horror movie and you need the external, uh, stimulation of someone else’s imagination.

Mine’s just running that all the time. 

Will: Well, I guess, let’s start here. Tell us why, like, litigation, why this is something that, that we should talk about. Because this is a lot of times this is kind of a taboo topic, right? We don’t we don’t just a lot of this isn’t out in the open and so why is this important for I guess not just Physicians, but anybody in health care to discuss.

Dr. Gita Pensa: Well the most important reason I think is that our keeping this subject taboo It really perpetuates this culture of shame [00:09:00] that we have around litigation, but litigation happens to, I mean, you, you speak as someone who, it sounds like you probably haven’t been sued from the way that you’re I have not.

Kristin: Can you tell? 

Dr. Gita Pensa: knock on all the wood for you. Um, but, but you probably, I don’t know, when you were a student or a resident, do you think you could have named any attendings of yours who had been sued? Did you know when any of them were being sued? 

Will: I didn’t. No, you didn’t. I didn’t. They didn’t. I guess. I can’t think of any, and maybe they just, they probably just didn’t talk about it so much.

I mean, I, I, I’ve heard, I’ve heard people like at conferences, like, like, like it was a topic of conversation at a conference, but I feel like it’s… No personal stories. Oh wait, that’s not true. I mean, no, somebody I work with. Yeah, yeah, so not in residency, but I have heard some stories from people I’ve worked 

Dr. Gita Pensa: with.

Since then, right. But you weren’t trained in any way. You weren’t trained in any way. No, no. Watching someone as a role model go through, you had no like role models of resilience, you had, you know, your department chair, no one was saying like, oh, I’m [00:10:00] going through this now, this is how I webbed it. You don’t have any, there’s no, uh, sort of generational knowledge in medicine being passed from like attendings to young physicians to medical students or anything like that.

And the way this became, Really important to me was that I got sued, um, and, uh, to make it a super long story, uh, shorter, um, I was named, uh, I was about five years out of residency, and I was, at the time I was a nocturnist, so I was an emergency physician, um, in a community hospital working. Nights and there was no hospitalist at night.

So I used to be the only doctor in the hospital, so I used to like have to leave the emergency department to like run a code and then come back down. And then there was a, an l and d labor and delivery, uh, labor and delivery floor, but there was no OB in house. And so I would’ve to go up and like maybe deliver a baby and come back down.

And the whole thing was terrifying and exhilarating and awesome. And I thought that I was really, really good at it. And then, um, one day I took care of this woman. And I won’t, right now, get into the case except that, Will, the [00:11:00] chief complaint was eye pain. Uh, I know. However, um, it was very, it was super, no, this wasn’t the L& D floor, this was just actually the emergency department.

She came in, she had this NE. Yeah, in the emergency department she had eye pain and, um, I didn’t, it was weird. Which you guys 

Will: love. You love the eye pain patients, right? We love the eye pain. One of your favorites. 

Dr. Gita Pensa: Okay. Certainly me now, you can imagine how much I love eye pain. And she wound up having, I, I didn’t, I didn’t find it.

I looked for a lot of things. I woke up an ophthalmologist in the middle of the night. I did, I did so many things and then I sent her home and then something really, with a plan to see the ophthalmologist by the way at like 9, I sent her home at 630 and then somewhere between now and the ophthalmologist appointment, she had a massive stroke and she was 30 years old and she was an engineer and so if you know anything about litigation, what that equals is a very high demand case.

You have a young person, high damages, and um, lots of economic potential, uh, and that means that they are coming [00:12:00] after you for a lot, a lot, a 

Kristin: lot of money. Thorough 

Dr. Gita Pensa: personality, probably. Right. Right. It was just, it was, it was not a good, it was not a good situation, but the worst thing for me was when I got named, I didn’t know anything.

I didn’t know anything. I didn’t know who to call. I didn’t know, I didn’t know who insured me. I didn’t know what I was supposed to do because when I was trained as a resident, I got risk management lectures. Like, they told me how not to get sued. They didn’t tell me anything about what to do once, you know, once the finger is pointed at you, what do you do, right?

So, but no one had ever said. So, the implication is, if you are good, It won’t happen to you, even though abstractly you know the numbers, right? You know the numbers that most physicians, that they practice for 30 years, most of us, especially in a high risk field, most of us are going to get sued, right? And we can’t all be bad doctors, so you figure, you know, well, like, maybe it’s going to happen, but you kind of put this thing on where like, that’s a horror [00:13:00] movie that happens to other people.

Right. Does 

Will: not happen to me. Like I just 

Dr. Gita Pensa: said, yeah, exactly. Like I said, right? It doesn’t happen to me. Um, and then when it does, Everything kind of crumbles in your identity where you feel like, you know, no one I know or no one who trained me or nobody who I, you know, this doesn’t happen, it’s not supposed to happen to me.

I don’t know what to do. I don’t, I don’t have anyone to talk to. You show up finally and you figure out who to call and you wind up in your insurer’s office and the first thing they tell you is don’t talk about it. So you don’t, except that there is this thing happening inside your brain. And it’s not good, right?

There’s a lot of pain and grief and I was really, I felt awful about what happened to this woman. I wanted to like call her or talk to her. Obviously you can’t do that, right? I didn’t understand what had happened. I was dealing with this whole like crushing identity, like loss of identity thing. I thought I was so good at what I did and all of a sudden I was like, I was wrong.

Like I spent [00:14:00] decades of my life to become this thing and I suck at it. And now the whole world is going to see that I suck at it because there is going to be a multi million verdict, multi million dollar verdict against me, and it’s going to be front page news in the paper. And so when I say this is a long story, what happened was, um, it, it took 12 years, like it took 12 years of my life to wrap this thing up.

12 years. 12 years. I was on, um, I saw this patient in 2006. Uh, and I, let’s see, went on trial for the first time in 2011, and then there was an, I won, um, and that was a four and a half week trial, it was incredibly grueling. And then, uh, there was an appeal. And, uh, my case went through all the layers of the courts and then the verdict got overturned in 2015.

And I went on trial a second time in 2018 and I won a second time and then they declined to [00:15:00] appeal. And so when I talk about litigation stress, I talk about it from, What was, from an understanding of what it was to be the person who was highly, highly distressed by this process and did not have any help and did not know who to talk to and was trying to like raise three kids, keep working, keep my head above water.

No one suggested therapy. There was no support group and I thought terrible things like on the daily, but it lasted for a really long time. And it wasn’t until probably 8 or 9, it was probably around the time that my verdict got overturned. Um, when I was, I mean I went back to work after the first trial, but I was really in a bad, I was not well.

Um, but we do what doctors do, which is keep like, just keep showing up, cause that’s what you do. Gotta keep working, just keep showing up. Very 

Will: unhappy. To hell with your mental health. You gotta shift. No, you 

Dr. Gita Pensa: show up, you gotta shift, right? And so, um, but then I, I [00:16:00] really, when they were like, you’re going back to trial.

I was, no, no, no, no, no, no, no. 

Will: How long was the gap between the trials? 

Dr. Gita Pensa: Uh, well, like 2011? 6 years? 7 years? And then 2015, it took 4 years to overturn the verdict and then it took 3 more years to go back to trial. But something happened then. Yeah. Where I, decided, like, I can’t be like this anymore. And, like, there needs, there has to be someone in the world that, like, knows how to do this better than me.

Like, I can’t, I, how could this be that we let, like, I thought of myself as a pretty, like, by then I’d gotten some self esteem back. I’m like, I’m a pretty normal, like, good doctor. Like, I’m a good person. I don’t have a lot of, like, usually mental difficulties. I cannot handle this. Like, why, Why is there no, like, why is there no help for me?

Uh, And then I started looking for it. So that is where all this comes from. And so, to a very long, uh, answer to your initial question, which is why does [00:17:00] it matter that we talk about this? Because that’s how you change culture. I, I don’t believe that litigation has to be this career ending Occasionally life ending, we should probably talk about that, right, but this should not be the life destroyer that it is for many physicians.

Like I, I think it’s appropriate to, you know, you can be upset and you’ll probably suffer a little bit. And this is what I do now as a coach. I’m a coach for physicians who are undergoing litigation. Um. There will be some suffering, but there is a way that we can adjust what our mindset is about litigation to make this not about, this is not about us.

This is not about you as an individual. It’s happening to you. Yeah, it’s not 

Kristin: a statement of your worth 

Dr. Gita Pensa: as a human. No, it is not. As a doctor, yeah. It is not and this And, but that is how we interpret it. And so to change culture, you’ve got to talk. 

Will: Now, you mentioned, uh, you know, high, high risk specialties.

What, what are [00:18:00] those specialties? Because you’re, you obviously, I’m sure you talk with a lot of different physicians, uh, you know, through your coaching and the classes that you teach and the lectures you give. What are you, I’m sure you see themes, right, on certain types of physicians. 

Dr. Gita Pensa: Oh, gosh. Yeah. I could really talk about that.

Um, so yeah. How many ophthalmologists do you 

Will: see? 

Dr. Gita Pensa: I actually just gave a talk to a whole group of ophthalmologists and there were a number of people in that room who were just like, Oh yeah, I got sued. Like it was, you know, once you start talking about it, people start talking about it. But, um, well, I 

Kristin: haven’t read your procedures.

Which is, and you don’t have to say what it is because I don’t want to do any identifying anybody But, uh, but did you, when she gave you the details, eye pain, then a stroke Oh, did you know in your mind what a potential diagnosis would have been or no? 

Will: No, I mean, I, I don’t know. That could be[00:19:00] 

Kristin: a lot of 

Dr. Gita Pensa: different things. So is and you. Even now it doesn’t make great sense. 

Will: But I will say, it’s, it’s, it’s very often that we get a call in the middle of the night from the emergency physician. And I say, that’s what he says. We’ll see 

Kristin: him in 

Will: the morning, first thing in the morning. And we’ll take a look.

And so it. That does, that kind of made my stomach drop a little bit to hear like, Oh, you know, we get into this, the longer we’ve been in practice, like you get into this, um, you know, this, um, mindset that, you know, it’s going to, this, this, this patient, whatever is going on, it’s going to behave like everything else.

And nothing’s going to change over the next six hours. It’s very easy to kind of just You know, reassure yourself in that way, and then, oh, it’s only six hours. Like, what’s the difference? You know, I’ll see, I’ll see the patient in the morning. But then, you know, things can happen. And so it is a little, it is scary to hear 

Dr. Gita Pensa: that.

Yeah. And it’s not, I mean, I don’t want to, I don’t tell, you know, I don’t tell these stories to scare [00:20:00] people. It’s interesting because I talk to a lot of, I do a lot of speaking on this topic. And, um, sometimes people are like, Oh, I think, I think it scares people. I don’t know if you should talk to learners.

I don’t know if you should talk to medical students about this. And I, I push back on all of that. Um, I think it’s important to know that things happen. You can understand that they’re rare, but when we set this expectation up for doctors, right, that like we, we, we, we. attract perfectionists to the specialty, right?

Like that’s, we, we breed perfectionism too as we go along, right? We only want the people who can get all the scores and this and that, and you jump through all the hoops and you do all the things. And so these are all perfectionists that are coming through here. And then, you know, we, when you actually practice medicine, as, as you just said, like we’re always operating in the gray.

We’re always operating in the gray. Like there’s, you know, sometimes, you know, eye pain, stroke, like, I don’t know, I gotta think about that one. Like there’s a lot of things that happen [00:21:00] in medicine that aren’t concrete. Most of what happens in a day, like if you don’t ask yourself the question, like a thousand times during a day, like, should I do this or should I do that?

Should I give this med or should I give that med? Or like, oh, should we do this procedure or that procedure? For me, should I send this person home or should I keep them? Or should I do that CAT scan? Like. How many times a day do we ask these questions that don’t have real answers, 

Will: right? Exactly. So many decisions, right?

Dr. Gita Pensa: But then we put this, this bar of like, you may never make a mistake and there must never be an adverse event and you basically are tasked with the impossible. That’s an impossible ask, right? And then the punishment for not achieving the impossible is quite severe. And that is something that most people, like, we can’t operate like that forever.

And so maybe we should ask ourselves the question of like, is that actually a reasonable expectation? And what is it in our culture that breeds that expectation for us? And we, how do [00:22:00] we keep it all alive? Because we do. And so, and these times in so many ways. To just the struggle of physicians right now.

Kristin: Right. Yeah, the idea that you shouldn’t talk to, to trainees about it because it’s scary. It’s like, well, it’s a reality and life is scary sometimes and that doesn’t mean we shouldn’t talk about it. And what’s scarier? Having been trained in what to do if it happens or just being out on your own when it happens and not having any of the resources or knowledge to know how to, to deal with it.

So I think that’s a flawed argument. 

Will: I’m telling you, like… There is so much you don’t know about the healthcare system, about practicing medicine, um, that you, you learn about once you get into practice, you know? Uh, and I think, uh, I think there’s a big part of that is just. Failure of the education system and realizing what we need to focus on and some of the real world problems.

Uh, I’m, [00:23:00] right now my head is full of all these healthcare topics. I’ve been doing this video series on the U. S. 

Dr. Gita Pensa: healthcare system. I want to ask you something about that, but go ahead. 

Will: Yeah, and, and it’s, it’s just like I am learning so much about things that, that are not directly related to my job, but do affect.

What I do as a physician, you know, things that are below the surface like pharmacy benefit managers and, and how, uh, you know, the, just the, so much about the pharmaceutical industry that we don’t learn as physicians, um, and, and some of the, the ways that the health insurance companies work and, uh, in denying claims and, and all these payment processing fees and billing.

And I don’t know, it’s just, there’s so much. Left on the bone that we don’t get to in medical education medical training that we need to even like 

Kristin: how to run a business I mean you guys don’t get taught that at all in your medical training and is it any surprise then that Why would equity [00:24:00] is? Running rampant if you don’t feel like you know how to run a business Then an offer to take care of that for you will be very attractive.

Don’t you think 

Will: why would we? Learn how to run a business, but we’ll all be working for UnitedHealthcare. Exactly my point. I don’t understand why. 

Kristin: Exactly my 

Will: point. But I want, I did, I want to, I want to get back to, you were going to answer the question of high risk specialties. High risk specialties. I’d like to know 

Dr. Gita Pensa: what those are.

So probably the highest risk are, um, OBGYN and, uh, general surgery, the surgical subspecialties, neurosurgery. Um, emergency medicine’s sort of top there in the top third. There’s, I mean, here’s the thing. That, um, I, even medicals, you’re not safe, Will, nobody is, nobody is safe. And actually, you know, some of the people that take it the hardest that I work with are people who were, who like went into a specialty thinking it was safe.

You know, I talked to medical students and sometimes they want to [00:25:00] know, they want to know what the high risk specialties are so they, they don’t do them. And then when, you know, when you wind up being, um, you know, say family practitioners don’t get sued as often as, as, as other. When you are a family physician and you’re getting sued, somehow it’s harder because you have this, this feeling that this was not meant to happen, this wasn’t supposed to happen.

I was, I was going into a field that was supposed to be safer and maybe that means I’m an even worse doctor because like it’s supposed to be rare. It, you know, some, in some states I work with people who, cause I, I, you know, I work with people from all over the country and. You know, in states where they have greater protections, people are still getting sued.

And when they finally, they’re just like, it wasn’t supposed to happen because I live in this state. And now I’m like one of the, these few people getting sued in this state. And now people must think that I’m like the worst thing ever because I live here and I’m getting sued. So it’s, I don’t know, it’s, it’s really a double edged sword.

There’s really, there isn’t any getting, it’s like [00:26:00] death at the marketplace, right? Like it’s going to find you, it’s going to find you somehow, and it would be far better If you were, so one of my big questions, oh, we can, maybe we can talk a little bit more about how I got to doing what I do, but one of my big questions when I was sort of moving forward as, in terms of thinking like, how, how do we get ourselves out of this?

The two big questions really is like, one, what, what would it take for doctors to be clear eyed about litigation? Like, what would it take for them to understand not just the skill set, but the mindset, everything that you need to be like, okay, I can face this. Like, what would it take for them to be clear eyed about litigation?

And what would the direct and indirect benefits of that be? And I asked that question because what I know now is that like, what I went through And that degree of suffering and like really rock bottom type stuff was not [00:27:00] singular. at all. Like I know that that’s not, it’s really common. And I know that litigation now, at least we have some data, but we know that litigation is a driver of suicide and of substance abuse and of, you know, divorce and certainly of career abandonment.

We know all those things. Um, it has a tremendous effect on families. Like I was my, I was pregnant with my third child when I saw this patient. And when I finished up, she was in middle school and these, my three kids had grown up with this as like this dysfunctional thing that their mother was like, I don’t even like to think about how it was sometimes, like the degree of stress that I was under and just like everything I did just to try to keep my stuff together, but it wasn’t working a lot of the time.

Um, so what was the, the direct and the indirect? effects of that be? Like, how would they practice differently? Would they practice less defensively? Would you have a better relationship with your patients? Like, would you be, you know, unafraid to try new procedures that might help [00:28:00] people? Would you, what, what would the, what would all those effects be if we could come into this process knowing how to deal with it?

And actually, like, people laugh when I say, like, I’m really, like, if I If I get deposed, if I have to prepare to, um, testify at trial, like, I’m good at that. Like, I invited my residents to my second trial to watch me testify. Oh, really? Yeah, because I know I’m, I know I’m good at it. It’s a skill set and a mindset, right?

You can be good at something and it’s not a bad thing to be good at. Sure. Um, and so, I mean, those are really the things that were, that were driving me forward, but it’s just, you know, where do we start? It’s a big, big project. 

Will: Right. Right. And so where. Where do you recommend that people start when they, like, I can’t imagine Well, can you talk about that?

Just that first moment when you learned that you were Getting, there was litigation against you. Like that, where were you? [00:29:00] Like what, if you don’t mind talking about it, like What’s that, what is that, what is that feeling like? Because I imagine that’s, that’s got to be one of the hardest moments. Yeah. 

Dr. Gita Pensa: I, I talk, so I, when I talk about this, I do talk about that moment.

Um, and there’s, um, I’ll mention I have a, I have a podcast curriculum, it’s called Doctors and Litigation, the L word. And there is an episode where people talk about what that was like. And so, and there was somebody talking about getting served at Thanksgiving and somebody talking about getting served the day after her father.

After her father’s funeral, and like, and just people getting served by sheriffs at work. So mine was not as dramatic in terms of like, I was just served by a process server at work, and actually they didn’t do it in the emergency department, I was in my chairman’s office. And so it was, Okay, except that I was like, it didn’t matter, like that drama part of it was taken out of the equation, which by the way, people don’t understand, that’s like an opening salvo.

When you get served on Thanksgiving or [00:30:00] when you get served by a sheriff at work, that is a strategic play. People do not understand the strategy involved in this, but oh yeah, oh my gosh, like plaintiff attorneys understand the psychology of physicians. And we are blind to the deliberate emotional manipulation baked into this process.

We are, this is again, part of the problem. We are completely blind to the manipulation. So anyway, for me, it was like, you know, like the whole bottom dropped out of the floor. I wanted to vomit. I had to sit down. I thought I was going to faint. I thought, Just so many thoughts all at once, but most of it was probably just like overwhelming like just fear and nausea and Also this sense like what happened like I don’t understand what happened How did this happen and then of course you’re really not supposed to like go digging around on the record or anything at that point You gotta leave that alone and wait, you know for Your lawyer is someone else to get you the records to look at, but just I [00:31:00] remember my heart going a million miles an hour and just at complete and total panic.

And also this feeling of like grief and guilt of like, you know, this person, she was a young person. She was a young person. She was an engineer and she came in to see me and something horrible happened to her on my watch. Right? So what do you do with that? Like, what do you do with that feeling? 

Kristin: It was horrible.

Yeah, 

Will: you know. It was horrible. Yeah, that’s and that’s the other side of this, right? That’s what I think why the the emotions are probably so complex. Yes is because Yeah, you’re you’re you’re sick for yourself. Like you don’t want to have to go through that this horrible process But there’s also somebody hurting on the other side and I don’t people I’m guessing the vast majority of the time, they’re not just, they don’t go through this just for the hell of it, right?

This is a huge thing. No, we like 

Dr. Gita Pensa: to say things like that, but I don’t think that’s true. Right. And I think when I talk about it too, I always, I, and I, I didn’t [00:32:00] today, but you know, when I usually give a talk or something like, like in my disclosures, I usually have a statement about how my talking about the suffering of physicians going through this process.

in no way negates the suffering of plaintiffs who have actually been harmed or who have had just bad things happen to them. Like they are also, for the most part, they are, so I’m not saying that there aren’t cases out there that are money grabs. There are. We all know that, right? But a lot of times, and, and, physicians have a different set of emotions around those, right?

Like you’re pissed off, you’re angry, you’re like, you know, you’re really angry at the system. But, you know, for the most part, a lot of times something bad happened to the patient. They didn’t understand. They don’t understand. They think it probably was you. And this is where we’re going to get back to me asking you about your insurance videos because somewhere for this case to happen, someone has told them that this is a valid case, right?

They’ve gone to an attorney. The attorney has a sentence, but if the attorney doesn’t know, what do they do? They find a medical [00:33:00] expert. And the medical expert, if I were, if I had your talents and I were making videos about this thing and I could make a video like I would take your peer to peer person from the insurance company and I would make that my medical expert, right?

Your medical expert who is making, you know, bank. At home, now, there are good medical experts, I’m also going to say that. There are great medical experts out there and we need more of them. But there are a lot of people out there who are, we call them test a liars, who will say or do anything for a buck, and the medical malpractice system would not survive without them, right?

There would be no frivolous litigation if there weren’t medical experts. Who are like, yeah, I’ll say that there was malpractice here. Yeah, go for it. I will testify for you for 600

Will: bucks an hour. Oh my 

Dr. Gita Pensa: gosh. Wow. I’m like, what would it take for me to get, to make videos 

Will: about my experiences? I want to, I want to explore [00:34:00] some of the, cause I know you have so many stories. I want to explore like some of the interactions with, you know, the, the, the, you know, those medical experts or the, the, the lawyers, the jurors, the judge, all that stuff.

Uh, but let’s take a quick break. All right. Okay. We’ll be right back.

Hey Kristen, how do I look? Oh, almost like a real doctor. I feel so natural with a stethoscope around my neck. Maybe I’ll wear one around the eye clinic. Oh, we’ll see what people say. Yeah, I don’t know, I might look a little off. Well… But you know, this isn’t just any stethoscope. Oh, what is it? This is the Echo Core 500 digital stethoscope with 3 lead ECG.

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Kristen, do you remember when I was trying to figure out what I wanted to do with my life after training? I do. Eventually, I decided on private practice, and it was the best decision I have ever made. Hey! Okay, Glockenflecken was probably the first. They have, very funny. But it’s really hard to start your own private practice.

It is, especially in today’s world. And that’s why Independent Practice Partners is there. They want to help you start your own practice, and they will ensure that your practice doesn’t just survive. To find out more, go to iPracticePartners. com. Again, that’s the letter I. PracticePartners. com.[00:36:00] 

Alright, we are back with Dr. Pensa and it was great, fascinating conversation so far. This is a whole world that we all need to know more about, but I want to know some of these, some of these interactions, some of these, these, uh, things you’ve experienced, um, both personally and just stories you’ve heard.

So please let us know. What is it like in the, the day to day grind of going through one of these cases and, and, and the depositions and interacting with, you know, lawyers and judges and all these things. 

Dr. Gita Pensa: Oh, wow. So that’s a lot. Um, actually, so you had Emily Silverman before, and so Emily Silverman, she did that.

I’m on one of those and I talk about like, what it’s like, you know, like walk in the courtroom and just the marble halls and there’s just all these sensations coming at you and I, I liken it very much to being like Alice in Wonderland, like you fall down a hole and you were like, what is happening right [00:37:00] now?

And, you know, you’re like the star of the show somehow, but you have no idea. Like, no idea what’s happening, no idea who to trust, no idea, like, should I eat that thing? They told me to eat it. I don’t know if that’s a good idea. Like, what’s going to happen to me if I eat that? Like, just, you don’t know anything.

Um, but, the process moves super, super slowly, right? And so, um, 

Will: I hear there’s a lot of poisonings happening in courtrooms, so yes, I totally, I get it, okay. 

Dr. Gita Pensa: Well, you have, there’s a generation that does not know Alice in Wonderland, I’m sorry, I’m old, so like, if you don’t know Alice in Wonderland, there’s like the eat me, drink me thing, like, that’s, like, that’s for, okay, I’m sorry, I’m showing my age.

Anyway. No, I’m with you, I’m with you, I got it. Um, well, I’ll tell you about my lawyer, so, my lawyer was really interesting, so I was very bad. I think that’s probably, that is, um, maybe an understatement, right? I show up to this guy’s office. I’m completely, like, completely all over the place emotionally. [00:38:00] And I feel like I’m supposed to be in charge here.

And I’m like, you need to just make this thing go away. Like, I don’t, like, I don’t think I did anything wrong. Make this thing go away. And I was mad. I was really mad. And my lawyer, So funny, we were like oil and water at first. Um, so he’s, so, people may not be watching, I’m a small person, right? I never really, you know, I thought I was very good at what I did.

I always thought of myself as a big dog, but I’m like 5’1 And, um, this little brown woman. And he was a big guy. He was older than me. And he was a very, very successful trial attorney. Like, really, like, the best around. Um, everyone was like, you gotta have him. And, um, I did not like him. I did not like him. He was, he had been, uh, he was ex military.

Not only was he ex military, he was like ex special forces. And that’s awesome, but he had no patience at all [00:39:00] for my, like, my mental anguish. None. None, none, none. And there was also this sort of like undercurrent of sexism that really bugged me about this whole thing where, you know, at some point. You know, we were, we were like knocking heads a lot at first, um, and he basically would just be like, shut up.

I know what I’m doing. Just stop. Like, stop trying to drive this bus. You don’t know how to drive it. And that was true. I didn’t know how to drive it at all. But I had this very much this feeling of like, I want to be in charge because I was used to being in charge. I was used to me. And I just, and I felt this need to control the situation that I could not control.

I was not the expert. 

Will: You needed to become the med student in this situation. 

Dr. Gita Pensa: I did. I was not putty in this man’s hands, like which I was supposed to be. Right. And so on like more than one occasion, like he would tell me to [00:40:00] like simmer down or to like, you know, not get my panties in a bunch or something.

And you, I,

I was so mad! Um, but he was really good at what he did. And he also recognized that I sucked at this and he got me a handler. So there was this junior attorney and all of a sudden I was his job. So another old reference, it was like a My Fair Lady thing. They were like, you’re gonna turn her into like a star witness.

And he was just like, Oh, no, I can’t do that. 

Kristin: A little bit of etiquette training for the courtroom. 

Dr. Gita Pensa: Exactly. And he was like, Oh, crap, like this is hard. Um, and he actually on that podcast, I do an episode about how to prepare for deposition. And I interview him about, like, what made me so bad and the things that, um, he had to teach me.

Oh, funny. And so we’d talk about, we’d talk about that process and so you can learn about how to perform for your deposition from Ryan [00:41:00] Deaty on that, on that podcast many, many years after he was my handler. Um, but it was just, it was just this really surreal situation, but the main attorney was really, really, really good at what he did.

And I now, uh, really interestingly have a, I’m, I’m starting a, I’m starting a company. I have two other co founders. Um, one is Shida Shafi, who’s a performance coach. Um, and the other is, um, Dorothea Calvano Lindquist, who is a trial attorney. And she was, she actually was a trial attorney in his firm that came just as I, my case was ending.

She was, she was She’d been working with him and, um, we just have such interesting stories about him. Um, he was just like a great, great, great guy, but just had this need to like, I had to get put in my place, um, which is a terrible thing. But one day he said to me Well, and that’s 

Kristin: probably how he knows how to lead and how to, you know, be in charge of a situation.

That’s what he was trained in. 

Dr. Gita Pensa: Yeah, exactly. And I was like having none of [00:42:00] it. Um, he, once he was like, stop acting like you’re the smartest person in the room. And I got so mad. I was just like, we are talking about vertebral artery dissections. Do you know what that is? Like, I know what that is. Do you know what that is?

No, you don’t know what that is. Nobody in this room knows what that is. I know what that is. I am the smartest person in the room And so really high emotions. And finally, he was just like, do you want to be the smartest person in the room? Or do you want to win this thing? And finally I was like, I want to win this thing.

Like, okay, right. So why don’t you work with me? I’m like, oh, fine. That was sort of the beginning of learning how to do this. And part of it is really like, you know, you gotta manage your emotions, um, and learn how it is that you’re supposed to show up. And it’s not what you think when you come in. Cause we want to come in.

Make the analogy all the time about like we, we play tennis, right? We’re like in our tennis ways and things are supposed to make [00:43:00] sense and blah, blah, blah. And then we show up there and they’re playing football and we’re just like, what am I supposed to do with my racket right now? Like I, why, why is, you know, and they are full on like tackle completely different sport and we are unprepared.

We’re totally 

Will: unprepared. Now these things don’t, don’t always go to trial though, right? No, barely. So I know you’re talking about preparing for trial, and I think they probably, is it they rarely go to trial? Aren’t these typically settled beforehand? 

Dr. Gita Pensa: Yeah, most of them settle. But when I say be prepared, I say, what, the thing that’s going to get you prepared the most is, is knowing how to think about it.

Like, understanding what’s going to happen, and understanding what your role is. Because so much of our anxiety is anticipatory anxiety, um, mostly because it’s just this big black box. You don’t know what’s going to happen, you’ve never watched, you’ve never even watched anyone go through it. No idea! Like, you’ve not seen, you didn’t see anybody do it, you [00:44:00] have literally zero knowledge.

about it. And so you come in just trying to act however you think you’re supposed to show up, which is mostly like completely emotional and shame ridden, or angry, or belligerent, or whatever. You don’t know how to be. And so a lot of it is really this cultivation of like understanding, mindset, what’s going to happen.

Maybe take the, take the, if there ever is another attending that says, come watch me testify, go. Because only a handful of my residents came. It was an open invitation. And when I asked some of them, why didn’t you come? They said they were scared. And they were like, it was just, it was really frightening. I just didn’t think I could deal with that.

Which is obviously that says something, right? 

Will: Yeah. So you’re, so you’re in the, You’re in the courtroom. I mean, this is, you said four and a half week trial initially, is that right? Yeah. 

Dr. Gita Pensa: Yeah. My first one was four and a half weeks. Second one was closer to three, but yeah. 

Will: So, so you’re, you’re just, you’re sitting there [00:45:00] and, and how much are you just…

Are you, like, analyzing the reactions of the jurors and, like, the judge and, like, oh my God, is this, are they, who started, I just can’t imagine, like, that mindset of sitting there and listening to this for 

Dr. Gita Pensa: four weeks. There’s so much to it. And so, but like you said, most people aren’t going to get there, but it’s so fascinating.

Like as someone who’s done the whole thing twice, and I am like a social experiment, right? Like I did the first one and I kind of got through and I won, but it was like. Super traumatic and then so it’s like trial A and then this whole like social intervention thing and then me as a defendant in 2018 as a totally different person, which to me is what proves that like skill set, mindset work, like learning about this can make you actually weather this well and perform with grace under pressure and do, you know, do a good job, right?

But it is, there are so many weird things about it. Like, all right, so, you know. The first thing that happens in any case is like jury selection, right? So first you walk in, they’re [00:46:00] clickety clack, all the courtrooms are all a marble or whatever, they’re very imposing. All, everything’s echoing around and like, you know, the sound is like echoing in your ears, and then you go inside and the room is quiet, and then…

They’re, if you’re there for jury selection, you’re not always there for it, but if you are there for jury selection, it is fascinating. There are so many times where I’d be like, I wish I were a passive observer in this process because this is really, really interesting, but, but I need to panic right now.

Um, and so they, you know, you. Here are these people, these good citizens of the public, who are coming in to adjudicate this case and watching the lawyers do this voir dire, it’s called, where they sort of get to ask, you know, they, a lot of times they’ll pull like numbers of jurors out of a bucket or something like that.

Turn whatever, whatever they use for the lottery, those things they turn around, they pull out numbers, the jury goes up, the juror goes up, potential juror, and they start asking them questions, right? And it’s really interesting. You find out all these random things about people’s lives. [00:47:00] And then the, the, how the, the lawyer is like, jockey to like, get people on the jury or dismiss people from the jury is also fascinating.

Like there was one time I remember, I was sitting with my lawyer during this process and every once in a while he’d like lean over me like pencil What’s your take? And I’d be like, uh, like I like that person. He’d be like you’re an idiot That’s not, no, we don’t want that person So like there was this really nice lady who I think of myself as I’m a pretty Like, I’m a pretty liberal person, and like, do I listen to NPR?

Yeah, I listen to that. And there was a woman up there who was, you know, she said they asked what radio stations or what do you listen to, what do you watch for news, all of that stuff matters, right? And um, she said she listened to NPR, blah, blah, blah. And I was like, I kind of, you know, afterwards, I kind of like that lady.

He was just like, you’re an idiot. Like, no, you don’t want the NPR people, like, you’re the man to those people. I’m like, I’m not the man. He’s like, you’re the man. You want 

Kristin: to go get coffee with that lady, but maybe you don’t want her as your [00:48:00] juror. 

Dr. Gita Pensa: It was really, really interesting. All the biases that come out and how, you know, the lawyers get.

To strike a couple of people, well, it changes all the time what the rules are, but they get to strike some jurors for cause, meaning they, they pull out some evidence of bias and they say like, okay, I don’t want this person on. So you’ll never get like a healthcare professional on the jury because the plaintiff’s attorney will be like, bye.

immediately. No way. Um, anyone who seems to understand medicine will not be on the jury. Um, anyone who’s says they’d had a good experience in medicine will not be on the jury. Like they will try to get all those people and then they can knock some people off like without cause as long as it’s not like racism or gender or whatever.

They’d get a couple of strikes, like, nope, not taking those people, but the, but there’s a certain number that they get. So the machinations that they go through to think about, like, do we want this one? Do we want that one? Like the questions that they ask to try and like, guess, like, is this going to be a favorable jury or not?

And for me, like, there was a lot of. He, again, coming down to like the sexism thing was really interesting. [00:49:00] He’s like, we want men on the jury. And I was like, what, excuse me? He’s like, men, men are gonna be more sympathetic to you. I was like, why? He’s like, just trust me. We want men. And I actually did wind up with a jury that was both times that were predominantly men.

And I don’t really understand the whys and wherefores of that, but he thought that that was. 

Kristin: Benevolent sexism. Yep. Where they feel like their job is to protect the 

Dr. Gita Pensa: cute little lady. Something like that, which also pissed me off, but I was, I learned to restrain that sort of thing. 

Will: You know, I served, I’ve served on a jury once.

Have you? I did. I did. Yes. When did that happen? This is a couple years ago, while we’ve been living here, but the jury selection was very… How did 

Dr. Gita Pensa: she not know? Where does she think you were? 

Will: It was like a four, four hour process of jury selection. The case itself lasted about 45 minutes, so it was, uh, it was all done in a day.

Yeah. 

Dr. Gita Pensa: Okay. That’s probably why I didn’t know. I thought it was probably just at work. They were like, Oh my God, four and a half [00:50:00] weeks. Are you kidding me? Yeah. 

Will: And that’s what I’m saying. Like, I can’t imagine that. Like, that’s. So 

Dr. Gita Pensa: you were asking about like, okay, like, so yeah, every day you come in and they’re trying to, they’re trying to, their whole job is to size you up.

Right. Cause they know nothing about like all these experts come in and we can talk about that too. But they come in and they like tell these. Stories and they’re supposed to be understanding and they’re all like nodding their head. They don’t understand a lot of like a complicated case. I mean they understand like someone you leave a sponge in somebody they get that, right?

But if we’re talking about like whether or not eye pain and vertebral artery dissection are supposed to go together somehow and whether or not I should have done X, Y, and Z or heparin versus aspirin, they don’t know. Now I’m thinking 

Will: about it. You’re 

Kristin: gonna be I can’t. Illuminating on this 

Will: one. I’ll tell you I mean, cause like, like a, like a central retinal artery occlusion that’s painless vision loss.

So I don’t know. I don’t know. Anyway. It doesn’t 

Dr. Gita Pensa: make sense. Please continue. Anyway, you’ll be like me, like every which way from Tuesday, trying to figure it out. It doesn’t make a lot of sense except that it put my whole life on [00:51:00] hold for a long time. I think, but. Two, 

Kristin: that the general public, which is what the jury is made of, has, you know.

can have this idea that in medicine there’s, there’s, it’s science, right? So there’s like a right way and a wrong way and there’s what you should do and what you shouldn’t do. And I don’t think there is really widespread understanding that it’s, it’s a little grayer than that. It’s not so black and white and there’s an art to it as well as a science and there’s not always one right answer or even a clear.

answer. 

Dr. Gita Pensa: Um, so that would be so tough. Like hoping you start to pin your hopes on people. Like for, for me, like, okay. So the optics start the minute you get there. Right. So my lawyer made me ride in the, like, And he had very nice cars. He did not drive them to court. And so I would have to meet him at his office every morning and I’d get in the back of this car and he used to hunt and he had hunting dogs and he would have all this dog crap in the, not actual crap, but like dog paraphernalia in the back.[00:52:00] 

Blankets and all that stuff. And I’d have to sit back with them and they’d be like, no, when we pull up, they’re going to watch you get out of the back of this truck. And I was like, okay. So I’d sit in the back of the, cause the, cause the handler lawyer was in the other front seat. So I sat in the back of the dog stuff.

And so from the moment, he’s like, when, from the minute you get out of that truck, you are acting a certain way. Like you are consummate professional. You say good morning to everybody. You hold the door, you smile politely. You are like. You are on from the minute you get out of here. You got that? I’m like, got it.

So like, I mean, really, you have to picture this guy. He was like, really, really something. So yes, sir. Yes, sir. I never got quite to yes, sir. But like, I did listen to him. But there was one juror. I mean, some jurors pay attention and some jurors don’t. They’re just people, right? There was one guy in one trial who 10 o’clock every day.

Like, he just, like, would settle in for his nap. And he [00:53:00] slept, like, he missed, so, so I’m like, that guy? That guy

is gonna be like, deciding your fate? God, that’s so On three separate occasions, jurors have come to the emergency department asking for me by name. Which is when I teach people how, when I talk to people about how to testify well at trial, you are testifying in a way so that they would want to join your practice.

They, they don’t need you to be perfect. They need you to be empathetic. They need you to show that you care about your patients, like you don’t even have to always be right. But if you could show grace under pressure. If you can be caring in the face of, like, a lot of stuff coming at you, if you can explain things well, um, they’re gonna, they love you.

That they want to. They really, they really want to. Um, and so they’re not looking for arrogance. They’re not looking for, like, this egomaniac. They’re not looking for the smartest person in the room. They are, they’re looking for someone who they would want to take their family to. And so I’ve had this [00:54:00] really interesting experience where…

Now two of the times I was there and one time I wasn’t, but that’s actually really, that’s a really interesting story because that person had a vertebral artery dissection and thought that they knew all about it, but they didn’t, but I didn’t get to take care of that person. But there was one guy, I’ll tell you this story because it was just, I don’t know, it’s just sort of emblematic of things that happen.

There was one. In one of the trials, I won’t, I won’t say which, but um, there was, you get your hopes pinned on someone because they’re like, there are people that seem like they’re paying attention, and you kind of watch their faces without being creepy, but you just try and, you know, you’re looking around the room politely, and you know that they’re watching you, um, but you’re also trying to see if you can…

Like, get them to look at you and see you as like a really nice, caring person. And there was one guy who I’d heard, like I heard the voir dire and I knew what he did and he did something, you know, he was very accomplished and had gone to Ivy League schools and did like, he was smart. And I was like, [00:55:00] that guy is going to get this.

He’s going to get that, like, I couldn’t have done anything else in this case. And like, I’m pinning all my hopes on this guy. And what you don’t realize is like. Sometimes you pass them in the hallway. Sometimes they’ll be at like a female drawer. They might be in the bathroom. Sometimes like you go to the bodega down the street to get something at lunch and then they come in after you and you’re not supposed to talk to them.

Right. But there is this sort of nonverbal thing going on. And so one day I, in a break, I was walking down the marble steps and he was walking up and you don’t want to not look at them. Cause that’s weird. Right. So I just was like, all right, that’s the guy. Like, that’s like, almost like, I don’t know, it’s just.

Like in high school, but I’m like, Oh my God, that’s the guy. Do I look at the guy? I don’t know. Uh, so I, so I looked at him and I had like what I thought was just sort of like a friendly look on my face and he looked at me and he smiled and I was like, Oh, okay. Okay. That guy’s probably on my side. That guy’s probably on my side.

And then I was really like, so you’re just doing this thing, this guessing game. Yeah. Until, and so when you testify and [00:56:00] you’re looking for the faces that you think are friendly, like you’re talking to the plaintiff’s attorney or your attorney. You’re talking to the jury. You’re trying to like look at the faces that you think are friendly.

Um, that happened a couple of times, like in the bodega, there was a guy that, you know, walking in, walking out. And I was like trying not to say anything and he was like, good morning doctor. And I was like, good morning. I was like, I got that one too. 

Kristin: But the 

Dr. Gita Pensa: guy who was really, you know, um, that guy that I pinned all my hopes on, you know, I was just so, you know, the.

Eventually it was a verdict in my favor and happy about everything. And then I don’t know how many months later, maybe six months later, um, working in the ER and the ambulance brings somebody in and it’s him. And he is highly, highly intoxicated. And he looks at me and he was like, Dr. Penza, and we’ve never spoken.

Like we’ve seen each other. We smiled at each other. Like we’ve [00:57:00] exchanged looks for like a month. Right. He looks at me and he goes, Dr. Penza, I love you. And. I’m really glad you’re here because I need help. Can I give you a hug? And normally I’m like, mm, on the hugs and the, like the people who come in who are intoxicated in the emergency department.

And have just 

Kristin: proclaimed love for you. Yeah, I was just like, 

Dr. Gita Pensa: okay, you know, and so I gave him a hug and so, uh, you know, he. He had an alcohol problem, had been sober for many, many, many years, very, very successful, fell off the wagon. And this is a hard thing in ER, there’s not a lot of, a lot of the resources aren’t, you know, there aren’t a ton of resources, but I actually did manage to get him into, um, I got him into detox and then he went to rehab.

And we actually saw him on and off for a while after that. And then, like, I saw him a couple more times and so did my colleagues. And then, um, And he got sober. Um, and so like a year after that, like we don’t get a lot of thank yous in emergency medicine, but he sent like cupcakes to the ER and was like a [00:58:00] year, a year sober.

And like, I feel like I have this real connection with you and, um, thank you for helping me get sober. And yeah, it was just really, it was really interesting. Um, and I’ve seen him like out and about. That’s, that’s a cool story. You know, yeah, it’s just one of these like strange things happen. Yeah, I mean there are people that like 

Will: In your community.

These are people in your community there’s on your trial your jury trial and and and then so it’s just we could continue talking to you for Forever. I mean, I’ve got so many questions, but we’ll maybe we’ll save it for another time I just want to thank you so much for joining us And I also I just think it’s you know, Kristen does this for her experience as a co survivor of medical trauma So much of what you said about just not Knowing where to turn, not knowing where to find information.

Yeah, I was thinking the same thing. As I, I’ve heard so many of the same things from Kristen about her experience, [00:59:00] um, with the healthcare system. And so thank you for, for taking that on this very important topic and putting together resources and something that, that physicians, that people can turn to for help.

Um, because, uh, clearly this, the psychological toll of this. topic of this on the people involved. It’s just, it’s something that needed to be. We needed help with. I want to do a 

Kristin: little PSA, too, that, you know, things are scarier in the dark. Like, if you are ignorant about something willfully, it’s going to be scarier, you know?

Yes. Learning about something makes it less scary, not more scary. And watching something happen from a safe distance makes it less scary, not more scary. So I don’t know. I just, I get, I get the hesitancy and, you know, people don’t like to feel scared, but I think, you know, what I have learned in the many situations we’ve been in is the only.

You [01:00:00] know, way to get over that is to just push through it, just do the thing, and then you see that you can do the thing, and it’s not as scary the 

Dr. Gita Pensa: next time. A thousand percent. A thousand percent. Thank you. Well, tell us, 

Will: tell us where, um, where people can find you, the thing, the, your services that you provide, the resources, all this stuff.

Dr. Gita Pensa: Sure. So, uh, so my website is doctorsandlitigation. com. Uh, the podcast is called Doctors and Litigation the L word. Um, and, and they can find me, uh, at both of those, both of those sites. I am, uh, starting a company. Um, you will hopefully hear about us and our hope is to really, really change the way this is done.

I’m working with insurance companies and attorneys. I mentioned my partners. Um, our, our goal is, you know, really, I don’t want any doctor ever showing up the way that I showed up, um, completely unprepared, completely afraid, um, and I think that there are ways. from, you know, the insurer and the legal perspective, [01:01:00] from the educational perspective, from the individual physician perspective, to be unafraid to find out that information.

I think that we, I’m not arrogant enough to say that I know exactly how we should be doing this right now, but I, I have learned a lot coaching physicians through this in the last few years. Um, I’ve, and just like the, the messages I’ve received from people, like I know that we can do this better than we’re doing this now.

I know that we can. And so that’s, that’s where. That’s where I’m going. That’s great. 

Kristin: Well, good for you for creating what you, what you wanted that wasn’t there. You’re going to make a big difference to a lot of people. I 

Dr. Gita Pensa: hope so. Thank 

Will: you. And also, uh, Gita Pinsa on Instagram at Gita Pinsa MD on Twitter or X or whatever you want to call it.

Um, thank you so much for joining us. It really has been a pleasure speaking with you. This 

Dr. Gita Pensa: has been, can I say it’s a dream of mine? I don’t know. If I knew all I had to do was get sued to get on this show, I would have done it sooner. 

Will: You hear that, everyone? No, don’t, please, please don’t take that, uh, if the choices [01:02:00] between getting sued or coming on here, we’ll let you do it before you get sued.

No, it really . 

Kristin: Just tell our producers the links you’re willing to go to. Sure. No, 

Dr. Gita Pensa: exactly. , again, its been a real honor. 

Will: Thanks. Thank you. Thanks. Absolutely. Take care.

Fascinating 

Kristin: topic. Yeah, we could have just gone on for hours. There’s so much more to say. I, I think with all of that, yeah, I, 

Will: it definitely, I’m gonna check out her podcast. Yeah. Serious. I haven’t, I haven’t heard any of those. And, um, I just, uh, yeah. I, I like, I like things that, We should know about, but we don’t.

Right. 

Kristin: There’s so many of 

Will: them. It’s just, exactly, and um, it’s a, it’s a whole, like she mentioned several times, a whole different world. So, man. Yeah. And what a, just a harrowing, difficult, like, describing what it was like, twelve years. Yeah. Twelve years of your life to, to get through that. And I, I’ve heard that about, about litigation and [01:03:00] malpractice litigation, that it, it just can be years.

Right. And so, um. 

Kristin: Forever. I feel like that’s part of the. The tactic too, right? I mean, I think it’s it’s partly because our court system is crowded But but uh, but it does something psychologically to you when it goes on and on like that 

Will: So yeah, check out Dr. Gita Pensa and all the wonderful work she’s doing Thank you all for listening and we didn’t get to listen her stories today But this we we went a little long.

That’s okay. It was I couldn’t I had to listen as much as she could tell us, and I didn’t, but I didn’t want the episode to go like two or three hours long, but it easily could have. 

Kristin: So we haven’t forgotten the listener stories or the games, and that will be back, don’t worry. Can I tell you what the 

Will: game was going to be?

Sure! 

Kristin: Or do you want to use it again later and you don’t want to say so? 

Will: Well, no, it’s called Doctors and Lawyers and Such. Oh, okay. It [01:04:00] was like, I had a series of Latin phrases, and I was going to make you guess if they were doctor phrases or lawyer phrases. I’ll save it for another time though, because eventually I’m sure, in fact, hey, if you know of any like malpractice lawyers, I think that would be interesting to talk with like someone on the, if any militant malpractice lawyers want to come and talk with us, we’d love to hear you.

Have you, hear you, both, 

Kristin: um, or if you want to make up a Latin term and have us guess what it is, you can do that too. 

Will: There’s lots of ways to reach us. By the way, you can email us knockknockhigh at human content. com. We’re on all the social media platforms. You can hang out with us and our human content podcast family on Instagram and TikTok at humancontentpods.

Thank you all for the wonderful listeners. You’re all wonderful. You’re incredible. You’re fantastic, and you’re also leaving awesome reviews. I know all of you [01:05:00] are. Uh, if you subscribe and comment on your favorite podcasting app or on YouTube, we can give you a shoutout. Like Mindy on Apple said, the conversation with Ma Glockenflecken was one of the cutest and funniest things I’ve ever heard.

Oh, my mom is gonna eat that up. Oh yeah. She’s the character. Right now, she just heard that, and she is beaming. She is, she is, uh, just over the moon from that comment alone. Oh my 

Kristin: gosh, Ron! That’s what she just said. Ha ha ha 

Will: ha. Full video episodes are up every week on my YouTube channel at DGlockenflecken, so check that out.

We also have a Patreon, lots of fun perks bonus episodes where we react to medical shows and movies. We have a wonderful community, a little town like, uh, Pawnee, Indiana. 

Kristin: Oh, yeah. Yeah. But maybe a little more competent. 

Will: A little bit more competent. Yeah, exactly. Uh, we’re there, we’re active in the community, in the Knock Knock High member community.

Uh, early ad free episode access, as a Patreon [01:06:00] member. Interactive Q& A livestream events, much more. Patreon. com slash Glockenflecken, or go to Glockenflecken. 

Kristin: com. You know, I’m sure that the real Pawnee, Indiana is perfectly competent. We were obviously referencing the fictional version. I 

Will: don’t think Pawnee is a real place.

Kristin: Is it not? I think it I thought it was. We’ll have to look. 

Will: I’m like 99 percent sure Pawnee is not a real place. Let’s see. Okay, while she looks that up, uh, speaking of Patreon community perks, we have new member shoutout, Richard the First. I think that’s her first. Richard I. Richard the First. One of the two.

You can be Richard the First. It’s like, you’re like a royalty. Thank you, Richard, for joining. Patreon, 

Kristin: what is it? It was based on Munsee, that’s what I’m thinking of, which is where Jerry is from in the show. Oh, gotcha, okay, alright. So, my bad, I got those mixed up. 

Will: Shoutout to all the Jonathans, Patrick, Lucia, C, Sharon S, Omar, Edward K, Steven G, Ross Box, Jonathan F, V I’m struggling.

[01:07:00] Marion W., Mr. Grandaddy, Caitlin C, Brianna L, Dr. J, Chaver W, Leah D, K L, Rachel L, and Ann P. Thank you all. A virtual head nod to you. Patreon roulette, shout out to a random person from our emergency medicine tier. Shout out to Capt Maine Wearing. Being a Patreon. Pat. Patreon. . Patreon. A Patreon. Patreon. You, that’s right.

Thank you. Captain May. Captain Main wearing. Yes. I like your name. 

Kristin: He’s got lots of suggestions. I recognize that name does. He’s does, he’s always given us 

Will: some good suggestions. Yes, he does. He, I love those suggestions. Mm-hmm. , uh, that’s what we do. We listen to our community here. We get lots of fun comments and, and suggestions.

Thank you all for listening. We are your host Will and Kristen Flannery, also known as the Glock and Flein. A special thanks to our guest, Dr. Gita Pensa. Our executive producers are Will Flannery, Kristen Flannery, Aron Korney, Rob Goldman, and Shahnti Brooke. Our editor and engineer is Jason Portizzo. Our music is by Omer Ben Zvi.

Okay, big breath. To learn about our Knock Knock Highs, Program Disclaimer, Ethics Policy, Submission Verification, Licensing Terms, and HIPAA Release [01:08:00] Terms, you can go to Glockenflaggen. com or reach out to us at knockknockhigh at human content. com with any questions, concerns, or fun medical jokes. Or puns.

You know what? I think one of the games coming up is going to be like trivia about our program disclaimer and ethics policy. 

Kristin: Oh, that’s a good one. I think speaking of our patrons, I think they might be the only ones who listen all the way to this point. So, hi patrons! We 

Will: had a little live stream where I asked how many people listen this far into the podcast and they did!

They, absolutely, 

Kristin: I was, I was very impressed. They were sending you back some of the jokes that you make, so we know they really do. 

Will: Absolutely, so thank you. Knock Knock High is a human content production.

Dr. Gita Pensa: Goodbye.

Will: Kristen, would you say we have a busy life? 

Kristin: Yes, I would say. That’s an understatement. We got the kids. 

Will: Yeah, the house. [01:09:00] We got the podcast we run. Yep, our jobs. Yeah, I do film skits from time to time as well. Yeah, 

Kristin: we have a lot of demands on our time. 

Will: You know who else has a lot of demands on their time? Who?

Physicians. That is true. Yeah, and a lot of it’s documentation. Yeah. It really, it leads to burnout and everybody just feels overwhelmed. Like they can’t keep up. You know what would help with that? What? The Nuance Dragon Ambient Experience or DAX for short. What a cute name. I love that name, right? DAX. It just rolls off the ticket.

DAX. Give me some DAX. I need some DAX. Help us DAX, we need to be able to, uh, improve the patient physician relationship and DAX is here to help. It’s this AI powered ambient technology that just helps you with your documentation and, and just allows you to return to doing. What you want to do as a physician, take care of patients.

To learn more about the Nuance Dragon Ambient Experience or DAX, visit Nuance. com slash Discover DAX. [01:10:00] That’s N U A N C E dot com slash Discover D A X.