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By Doug Wojcieszak
St. Louis Post Dispatch
Thursday, Aug. 04 2005
Coventional wisdom: The on-going political battle over the medical liability
crisis is a polarized fight with no middle-ground solution in sight.
Actually, Illinois doctors, lawyers, and patients may find some middle ground
with a program called "Sorry Works!" This spring, Illinois lawmakers passed
legislation authorizing a pilot program providing incentives for doctors to try
it.
"Sorry Works" operates on the premise that openness, sincere apologies and
prompt compensation for medical mistakes actually reduce lawsuits and liability
expenses for doctors and insurance companies while providing swift justice for
victims. And by infusing the process with honesty, doctors learn from errors
and reduce recurrences, which further reduces liability exposure.
Legislators from Kentucky, Vermont, New Jersey, South Carolina, and Tennessee
have expressed interest in replicating the Illinois legislation. Federal
legislators are interested, too, having already introduced one bill (S. 1337),
with more "Sorry Works" legislation expected in the fall.
Here's how the approach works:
After a bad medical outcome (unanticipated death, unsuccessful surgery),
hospital administrators and doctors investigate the case to determine if their
medical treatment met the standard of care. The analysis may take from a few
weeks to a couple months, but hospital staff stays in close contact with the
patient or family throughout the process so they don't feel abandoned or
suspect a cover-up.
If the analysis shows that the standard of care was not met - if
there was error or negligence - the hospital schedules a face-to-face meeting
with the patient and family at which time the doctors apologize, provide
explanations, discuss how they will address the problem and offer fair, upfront
compensation for the consequences.
If, however, the investigation determines the bad outcome was not caused by
error (i.e, the patient was simply too sick), the hospital staff still meets
with the patient and family and their lawyer. Hospital officials explain what
happened, open medical charts and answer all questions. Simply put, they prove
their innocence, which reduces the non-meritorious cases that account for
60-to-80 percent of all medical malpractice lawsuits.
This forthright approach removes anger from patients and families, which is the
driving force behind most medical malpractice lawsuits; patients and families
simply want doctors to acknowledge mistakes and make amends.
The University of Michigan Hospital System says honesty has cut their lawsuits
in half. Furthermore, Michigan has saved $2 million in legal expenses annually
because cases are closed in months instead of dragging on for years. And
Michigan administrators report that because their doctors honestly review
errors, they have been able to improve medical care.
Twenty-eight hospitals in the Kaiser hospital system and 39 hospitals in the
Catholic Healthcare West system have gained reputations for being "straight
shooters" using this approach. When they say something wasn't their fault, they
are more likely to be believed by patients and lawyers.
COPIC insurance of Colorado reports similar results with a "Sorry Works"
approach. Malpractice claims against their 1,800 doctors have dropped by 50
percent since 2000 and settlement costs have fallen 23 percent.
Equally positive results are being reported at Children's Hospital of Minnesota
and at three Veterans Administration hospitals in Lexington, Los Angeles and
Las Vegas. The Lexington institution reports average settlement costs of
$16,000 per case versus the national VA average of $98,000 per case.
"Sorry Works" works because it addresses the root causes of the medical
liability crisis. "Sorry Works" improves the "inside culture" of hospitals,
while efforts at so-called tort reform - the more often prescribed cure for the
med-mal mess - focus on the "outside culture" of judges, juries and lawyers.
Tort reform tries to make it harder for people to file a lawsuit; "Sorry Works"
tries to make lawsuits unnecessary.
Finding middle ground in the medical malpractice crisis starts with one word:
"Sorry."
Doug Wojcieszak of Glen Carbon is a spokesman for The Sorry Works!
Coalition. He is a political activist and a former downstate director for the
Illinois House Republicans.
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