A Little Human Decency
“A soft answer turns away wrath,
But a harsh word stirs up anger.”
–Proverbs 15:1
Syndicated columnist Deroy Murdock has written about a movement in the medical community that seeks to use apologies to avoid malpractice lawsuits. The Sorry Works Coalition hopes that honesty and communication (and appropriate compensatory measures) will reduce the frequency of million-dollar malpractice torts.
This is an idea whose time has come. I’m sure most doctors who make mistakes would like to admit it and make it up to their patients. Unfortunately, the state of our legal system discourages open communication in these situations, leaving doctors and patients to communicate through their lawyers. I hope this idea catches on in other parts of society, too.
7 Responses to “A Little Human Decency”
The key, of course, is that the apology be inadmissible in court as evidence of fault.
I doubt if Sorry Works will revolutionize medical liability (there will always be the predatory segments of the plaintiff’s bar convincing people that they are victims and attaching $$ to that victimhood), but it’s a nice step.
I’ve been in this situation myself. My mother died after going into cardiac arrest following a minor surgery, before she had woken up from the anesthesia. When she went into cardiac arrest, the doctors put her on a ventilator and when they turned on the air, it blew a hole in her lung. The surgeon told me and my stepfather that the next day, and explained that it was a calculated risk that they felt they had to take. He took an extraordinary risk telling us that. I’m sure many other people would have immediately filed a malpractice suit just hoping to get a settlement out of it. Which is really a shame. Those doctors were incredible. They did everything they could possibly have done to keep my mother alive. It would have been a grave injustice had they been charged with malpractice. And one of my siblings still does not know about this because we all know she would go and file a suit if she knew. It’s a shame that rationality and common sense is so often trumped by dollar signs.
While our legal system indeed makes it difficult, if not impossible, for physicians to express their sincere apologies to their patients, (without fear of such statements being used against them,) one thing they CAN do to reduce the chances of a million dollar malpractice tort action is work diligently to develop a positive relationship with each and every patient.
Blowing a patient off is a sure way to cause anger and provide impetus for him or her to call an attorney if they feel they’ve been harmed.
Some physicians, especially anesthesiologists, don’t get a chance to develop relationships. PCPs, e.g., can, but some others are more task-oriented than patient-oriented. Is this the reason, above many others, that the gas men and women are at or near the top of the list of most-sued physicians? It seems reasonable.
Adam – perhaps. But sometimes even anesthesiologists could develop more of a connection than they do. The simple act of introducing oneself to a patient BEFORE the time for pre-op prep has arrived can do wonders for making a patient feel at ease. And in emergency situations where this isn’t possible, sticking around after the immediate recovery period (or checking back in briefly the next day) for a moment to make sure the patient is doing well – showing the patient concern for his or her well-being – is a nice (and rare) touch.
As a physician in one of those highly sued specialties I have practiced for 15 years and managed to avoid a suit to this point. (Knock on wood) I feel I have a fairly good handle on the target side of the interaction. I do try to establish a relatively friendly and trusting relationship with patients, and when something goes not completely according to plan the best approach is a tactful but honest explanation, including why (if you know why) something happened.
Unfortunately medicine is not an exact science, and outcomes that were entirely unpredictable can and do happen. I know of physicians – many, actually – who have been sued even when they did literally nothing wrong, but the patient simply had a less than desireable outcome. I know of one physician who was sued when it was the patient’s own self destructive behavior that led to the bad outcome. This patient insisted on leaving the hospital early to go home and smoke.
So, would an I’m Sorry policy work? In a few cases, but not in all that many. The other day my partner was seeing a patient in the ER with a hand injury, and after explaining what had to be repaired, and that he would do it for the patient, the patient said to him, “So, if this goes wrong I can sue you?” This was before the work had even been done. How do you deal with that?
To the doubters I appreciate your comments and concerns. Look at all the hospitals that are doing Sorry Works! successfully: Lexington VA, University of Michigan, Kaiser Hospitals, Catholic Healthcare West, etc, etc. These facilities have reduced their lawsuits and liability costs by apologizing and offering fair upfront compensation for medical errors.
Sorry does work. Why? Because it strengthens – not weakens – physicians when it comes to litigation. Any good trial lawyer will tell that the best targets are liars and cheaters, not honest, sympathetic defendants. If you think I’m naive, then I refer you back to the hospitals that have made sorry their path to success.
Doug Wojcieszak
The Sorry Works! Coalition
618-559-8168