[Mb-civic] When doctors say they're sorry - Doug Wojcieszak - The Boston Globe

[William Swiggard]

When doctors say they're sorry

By Doug Wojcieszak  |  August 25, 2005

RECENT NEWS stories report that Harvard Medical School's major teaching 
hospitals are actually encouraging their doctors to apologize for 
medical errors. Given our litigious culture, this unusual move looks 
like a ready-made gift for greedy trial lawyers -- or is it?

Actually not. In fact, apologizing for medical errors has been shown to 
reduce lawsuits and liability costs in hospitals across America.

The first hospital to implement apologies for errors was the Lexington, 
Ky., Veterans Administration Hospital. After being stung by two 
multimillion-dollar lawsuits in the mid-'80s, hospital leaders 
instituted a policy of apologizing for all medical errors and offering 
fair, upfront compensation to patients, families, and their attorneys.

Conventional wisdom said they were crazy, but the Lexington staff 
happily reported in the December 1999 edition of Annals of Internal 
Medicine that their facility ranked in the lowest quartile of VA 
facilities for malpractice payouts; their average settlement per case 
was $16,000 compared with the national VA average of $98,000. The 
Lexington approach spread to VA hospitals in Los Angeles and Las Vegas 
and then to the University of Michigan's hospital system, which has cut 
its lawsuits in half. Michigan also reports saving $2 million in defense 
litigation expenses annually because cases are being settled in months 
instead of dragging out for years. Similar positive results have been 
reported at 28 Kaiser hospitals and 39 hospitals in the Catholic 
Healthcare West System.

Honesty programs vary from hospital to hospital, but they usually follow 
a similar protocol.

After a bad outcome (unanticipated death, unsuccessful surgery), 
hospital administrators and doctors determine whether the standard of 
care was met.

If the investigation shows that the standard of care was not met (i.e, 
error or negligence), the hospital schedules a meeting with the patient 
and family at which time the doctors apologize, provide explanations, 
and offer fair, upfront compensation for the injuries.

If, however, the investigation determines that the bad outcome was not 
caused by error (i.e, the patient was simply too sick), the hospital 
staff still meets with the patient/family and their legal counsel. They 
explain what happened, open medical charts, and answer all questions. 
Simply put, they prove their innocence, which reduces the nonmeritorious 
cases that account for 60 to 80 percent of all medical malpractice lawsuits.

http://www.boston.com/news/globe/editorial_opinion/oped/articles/2005/08/25/when_doctors_say_theyre_sorry/
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