Sonographers’ perspectives towards the increase in medico-legal litigation: An exploratory qualitative study

Abstract

Introduction: Medico-legal litigation is increasing within sonography, a profession already affected by high levels of occupational burnout and ongoing recruitment and retention challenges. Despite this trend, little research has explored how the possibility of litigation affects sonographers’ well-being or influences their professional practice. Method: This qualitative descriptive study was conducted in the United Kingdom. Purposive voluntary sampling recruited six National Health Service sonographers via social media. Online semi-structured interviews explored their perspectives on rising medico-legal litigation. Data were analysed using reflexive thematic analysis. Results: Four themes were identified: (1) The emotional and psychological burden, (2) The impact on sonography practices, (3) Work-related pressures, and (4) Supporting the sonographer. Litigation fear affected well-being and contributed to defensive behaviours, particularly in report writing. Participants also described systemic pressures, such as workload demands, limited appointment times, and misunderstandings about the sonographer’s role that increased the perceived risk of error and potential litigation. While transparency and professional accountability was valued, many highlighted the need for clearer guidance, learning opportunities, and stronger organisational support. Conclusion: Sonographers reported fear and uncertainty surrounding medico-legal litigation, alongside pressures that shaped both practice and emotional well-being. Although these concerns were prominent, participants also recognised the importance of transparency and accountability when supported by fair processes. Enhancing guidance, training, and organisational support may help reduce litigation fear and contribute to a more sustainable sonography workforce.