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Radical Idea for Med-Mal Cases: Apologize

If love means never having to say you're sorry, a medical mistake means never daring to say it. Fear of a lawsuit keeps doctors and other medical professionals from ever admitting they messed up.

But as Associated Press writer David N. Goodman reports, a Michigan hospital is defying the conventional wisdom, admitting mistakes and offering compensation well before patients file lawsuits. In taking this approach, the hospital has achieved something remarkable -- significant savings in money and time, not to mention the gratitude of its patients.

"What we are doing is common decency," lawyer Richard C. Boothman, chief risk officer for the University of Michigan Health System, tells AP. Common decency, it turns out, makes good business sense. By adopting a policy of open and honest disclosure, the system has seen the number of malpractice claims against it drop by half, from 136 in 1999 to 61 in 2006.

Boothman provides more details about his system's approach in an article he and four colleagues published earlier this year in the Journal of Health & Life Sciences Law and also in 2006 testimony he gave before the U.S. Senate Committee on Health, Education, Labor and Pensions. Notably, Boothman says that he came to his understanding of the value of an apology through 22 years as a med-mal defense lawyer.

Neither the "deny and defend" strategy common within the medical establishment nor state efforts at tort reform have any significant effect on reducing med-mal litigation, Boothman contends. This is because neither of these address the reasons patients consider litigation in the first place. "These reforms do nothing to ensure an explanation to an injured patient, ensure the safety of others, or ensure negligent healthcare systems and caregivers are accountable."

The Michigan system's approach is to engage patients, their families and even their lawyers in an open dialogue about what happened and what do to about it. For "true mistakes," patients receive acknowledgment and an apology. In every case that turns out other than as expected, they receive a thorough explanation. At the same time, if the system believes its care was reasonable, it defends it "vigorously."

As noted above, this approach has reduced the number of claims against the system. It has also enabled the system to handle claims more quickly and to reduce the number of claims pending at any one time. In August 2001, the system was managing 262 open claims. By 2007, it had reduced that number to 83. During the same period, the average claim processing time dropped from 20.3 months to eight months.

As med-mal plaintiffs' lawyer Norman Tucker said to the AP, "You should follow Mark Twain's advice: 'When in doubt, tell the truth.'" To which I would add: And when wrong, apologize.

Posted by Robert J. Ambrogi on September 3, 2009 at 02:51 PM | Permalink | Comments (4)


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