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You can probably think of a few times when a short apology soothed a tense situation, but can you remember a time when saying you were sorry reaped financial rewards? Simple as it sounds, apologizing for clinical errors has been shown to reduce medical malpractice lawsuits. By offering a sincere, accurate admission of regret, along with a promise to remedy the situation, you may be able to reduce your risk of a liability lawsuit.
Why apologies are worth it
Apologizing for a mistake can be complicated for O&P professionals, who make determinations about patient care in a world where expensive liability lawsuits are common. For instance: When is an apology due? What if a mistake did not result in tragedy, but merely an unintended, correctable outcome? How can a practitioner know whether his admission of wrongdoing will later come back to haunt him in a court of law? In addition, apologizing forces a clinician to confront fears of being sued, embarrassed or perceived as unprofessional.
Despite these issues, the movement toward "sorry policies"-empathizing with patients and apologizing for unfortunate or unintended outcomes-is gaining momentum. One group, the Sorry Works! Coalition (www.sorryworks.net), is a national group of patients, practitioners, hospital administrators, insurers and others who advocate sincerely apologizing for a clinical error, as well as offering prompt and fair compensation. Their goal-reducing litigation expenses-is based on the premise that most lawsuits are filed out of anger, not greed. They argue that establishing a sorry policy will ward off vindictive legal battles.
How it works
Here's how a sorry policy works. When an unintended outcome occurs, the practitioner and his insurance company's risk management team disclose all of the situation's details to the patient and the patient's family. Full disclosure, according to Dr. Steve Kraman, former chief of staff at the Lexington Veterans' Administration Medical Center, involves a direct, sympathetic and complete rendering of the facts of the patient's case to the patient. The practitioner should then apologize and promise a full review of the situation.
"If something bad happens, the very first thing that a medical professional can do is go to the family and say, 'I'm sorry this happened, I feel bad about it, you feel bad about it [and] we're going to do something about it right away,'" says Doug Wojcieszak, spokesperson for Sorry Works!
When apologizing, practitioners should avoid making statements like, "I shouldn't be you telling this, but…" or "We're sorry if you feel that way." Wojcieszak says that comments like those just make patients angrier, and therefore more likely to sue. Instead, be genuinely regretful. Avoid offhand remarks. Keep the lines of communication open and courteous.
According to Wojcieszak, the practitioner should also advise the patient to consult with a lawyer about the mistake and invite the patient to bring his or her lawyer to subsequent meetings, regardless of whether the case ultimately goes to litigation. Why? "Three words: credibility, credibility, credibility," says Wojcieszak. Being invited to bring a lawyer gives the patient confidence that the practitioner is looking out for the patient's interests. Additionally, lawyers often instruct patients to accept more reasonable compensation than they might demand otherwise.
You have the resources
Although sorry policies have met with success at several big hospitals, most small O&P facilities think they don't have the resources that those institutions do. But that's not true. Wojcieszak says that even facilities with just two or three staff members can reap big savings from sorry policies, and that, through their insurance carriers, they have access to the same kind of risk management services as big hospitals. In fact, your insurance carrier's risk management team will likely offer training in how to offer an apology-stick close to their guidelines.
Make it a program
"I get this question a lot: 'I want to do this. How do I get this going?'" says Wojcieszak. He strongly recommends establishing a formal program well before an actual mistake occurs. "This only works as a program," he says. "It isn't an ad-hoc, case-by-case, whatever-feels-right thing."
To that end, Wojcieszak suggests practitioners call their insurance carriers and ask how to set up a formal program. "Then, when the adverse event happens, there's a call and the program snaps into action," he says.
To protect practitioners, groups like Wojcieszak's push for so-called "apology legislation." Generally, under these laws, providers' apologetic expressions of sympathy (e.g., "I'm sorry you had to go through this.") cannot be used against them in court. In some states, the apology is inadmissible in court even when it includes an admission of fault. (For instance, "I'm sorry I fitted you incorrectly.") For a list of these states, see the sidebar, "Know Your State's Apology Law."
| Know Your State's Apology Law |
| Twenty-nine states have enacted laws excluding expressions of sympathy after accidents as proof of liability. They are: |
- Arizona
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Hawaii
- Illinois
- Louisiana
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- Maine
- Maryland
- Massachusetts
- Missouri
- Montana
- New Hampshire
- North Carolina
- Ohio
- Oklahoma
- Oregon
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- South Carolina
- South Dakota
- Tennessee
- Texas
- Vermont
- Virginia
- Washington
- West Virginia
- Wyoming
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Make it a principle
Aside from the possible financial benefits, apologizing for an unintended outcome or mistake can deepen patient relationships and emphasize your practice's honesty and integrity. But to do so, it can't exist only at the practitioner level.
Wojcieszak says that everyone affiliated with your company, from the person at the front desk to the person paying the bills and anyone in between, has got to be willing to change from a "defend-and-deny" patient-relations strategy to one of truly compassionate care. And a reputation like that is always good for business.
This article was adapted from information contained in "When and Why You Should Apologize to Patients," which was printed in Aon's 2006 HPSO Risk Advisor.
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