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APRIL 22, 2009
Doug Wojcieszak, Founder & Spokesperson
Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net
SORRY WORKS! EDITORIAL: DISCLOSURE & THE PHYSICIAN FEAR FACTOR
The disclosure movement is really gaining steam. We are doing more and more training, people continue to buy the Sorry Works! Book, and success stories are becoming more and more prevalent. Just a few weeks ago two major hospitals in New Jersey – New Jersey! – reported successes with Sorry Works! In fact, one of the hospitals said they have cut their lawsuits by half.
Yet, with all this positive momentum a large amount of fear remains with physicians. Three weeks ago a physician in Cleveland told Sorry Works! Founder Doug Wojcieszak that doctors are "just so afraid." It's like docs know disclosure is going to become common place eventually, but they have no idea what to say or do post- adverse event. Literally picture a deer in the head lights.
A common saying in the disclosure movement is "Get the leadership of the hospital or insurer to buy-in, and disclosure will happen. If, however, the C-suite doesn't buy-in, it will never happen." This statement is true, but physicians are a critical - absolutely critical - piece of the puzzle too. We must get them bought in to A) speed disclosure where the leadership of a hospital or insurer has approved disclosure or B) change the hearts and minds of leaders who do not accept disclosure.
We need to calm the fear felt by physicians. These fears are not unreasonable, and often are not the creation of doctors themselves. Physicians have had deny and defend drummed into their brains starting in medical school and throughout their careers by a plethora of defense lawyers, risk managers, claims experts, and c- suite personnel. Moreover, physicians have traditionally been ostracized and left with little support when being sued. Finally, physicians have been burned too often when the medicine is defensible but they are forced to settle a case - sometimes because the insurer decided it was cheaper to settle than fight, other times because the behavior of the physician after the adverse event made the case untenable.
Herein lays our openings to work with physicians: Sorry Works! is all about providing support. It's a support program for not only patients and families, but also docs!!
Any good disclosure program starts with training and education - the training needed to not only calm fears but also help docs make this 180 degree culture change. Hospitals and insurers need to provide the resources to docs 1) understand why disclosure is good for them as well as their patients and families and 2) teach them how to do Sorry Works! At Sorry Works! we can help with this training. Just give us a call at 618-559-8168 or e-mail doug@sorryworks.net for more information.
With this training, physicians will be able to provide empathy ("I'm sorry this happened") and good customer service in the immediate aftermath of an adverse event. Then, working in concert with the hospital and/or insurer and defense counsel, conduct a credible investigation to determine if a mistake happened - or not. The physician needs to understand that a team of trained people - trained in crisis communication - will join him/her in delivering the results of the investigation to the family. Furthermore, if a mistake did happen, this team will help the physician work through the process of providing economic and non-economic compensation to the patient/family. Finally, if a lawsuit is initiated (either because there is a disagreement about the standard of care or the value of damages), physicians must understand that this program will create great evidence for a strong defense. Cases of defensible medicine will not be settled, and cases where mistakes did happen will be merely be argued on the damages without the horror stories of arrogant, aloof physicians.
Teaching docs that Sorry Works! is a program is a must...a physician in New Jersey last week before a Sorry Works! presentation said he was skeptical that "sorry" would stop a lawsuit if he made a mistake. This well-meaning physician did not understand Sorry Works! is a program that docs use with their insurer/hospital to work with patients/families to fix problems in a pro-active fashion, thus lessening the need for litigation. After the Sorry Works! presentation, the same doctor told Sorry Works! Founder Doug Wojcieszak that he was now a believer in Sorry Works!
Finally, physicians need to understand that any good Sorry Works! program provides emotional support and other forms of assistance for providers struggling to deal with an error. Physicians are often the second victims of a medical error - and they need help too! Sorry Works! provides it.
The take-home message for docs is that Sorry Works! is all about providing them support. This is not "say you're sorry and we'll cancel your coverage." No, this is working with your insurer/hospital and defense counsel in a more proactive, expedited fashion to provide answers and - when necessary - a genuine apology to a patient/family.
To summarize, we at Sorry Works! strive to teach four main principles about disclosure to healthcare professionals:
1) Disclosure is good for providers as well as patients/families
2) Informed consent along with Five-Star customer service set the ground work for disclosure and begin building the positive chain of evidence.
3) Providers must be able to do the empathetic "I'm sorry" immediately after an adverse event without prematurely accepting or casting blame. Also, providers must be empowered to immediately address customer service concerns of patients/families struggling with an adverse event - needs such as food, lodging, transportation, child care issues, etc.
4) Immediately after the empathetic "I'm sorry," providers must call their risk management, insurer, and/or defense counsel to initiate a credible investigation which will lead to a resolution.
For more information on Sorry Works! Training, contact doug@sorryworks.net or call 618-559-8168.
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