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By Jessica Fargen
Boston Herald Health & Medical Reporter
Sunday, March 18, 2007
A proposed law in Massachusetts would give doctors more freedom to be honest with patients about medical errors without fear that their apologies might be used against them in court.
It's just one part of a national and local push to get more physicians to say "I'm sorry."
"Patients say, 'If I'd had an apology, it would have helped my own healing,'" said Deborah Wachenheim, coordinator of a consumer health quality group at Health Care for All, and backer of a proposed bill that would legally protect doctors who apologize. "Just hearing the apology can make such a huge difference."
The Bay State legislation, proposed by state Sen. Richard T. Moore (D-Uxbridge), chairman of the health care financing committee, would make doctors' statements of regret or admissions of errors to a patient or family inadmissible in court.
The bill is only one part of a cultural shift in the health care system in response to rising malpractice costs and a growing patient right-to-know movement.
Hospitals across the country, including many in the Boston area, have adopted so-called apology and disclosure policies, which can allow a physician to admit an error, explain what happened and apologize. Sometimes, the hospital offers money upfront to cover associated costs.
Doug Wojcieszak, spokesman for SorryWorks! Coalition, which advocates for apology and disclosure policies, said health systems around the country are slowly embracing the idea, which has cut down on malpractice claims and saved money at some hospitals.
"They've had this risk-management strategy for years - deny and defend," Wojcieszak said. "They think that's the way to limit lawsuits. What the experience has been is that doesn't prevent a lawsuit, it encourages one. They make people angry."
Medical errors also kill. About 100,000 people in this country die each year as a result of medical errors, according a national study.
Last year, the 14 Harvard-affiliated hospitals in Massachusetts agreed in principle to a consensus agreement that laid out an apology and disclosure policy, although hospitals have instituted their own individual procedures. Wojcieszak said some studies have shown that even with moderate to severe errors, patients are less likely to sue if a physician acknowledges a medical error.
"We've got to quit playing games with patients, said Dr. Lucian Leape, an adjunct professor at the Harvard School of Public Health and national patient-safety expert.
"A patient has a right to know absolutely everything. We have no right to keep anything from patients," said Leape, one of the authors of the Harvard agreement.
Dana-Farber Cancer Institute adopted a policy in 2001 that requires the hospital staff to acknowledge a medical error within 24 hours of its occurrence, prior to any investigation.
Maureen Connor, Dana-Farber's vice president of risk management, said the document gives doctors guidance and makes patients feel informed.
"Simply put, this is the right thing to do," said Connor, who also worked on the Harvard agreement.
Some physicians and attorneys say hospital policies must go hand-in- hand with legal protections, such as the one contained in Moore's bill, for true malpractice reform to work. Massachusetts doctors pay some of the country's highest medical malpractice insurance rates.
"The health-care providers need to be assured that they will be reasonably protected under those policies," said John P. Ryan, a Boston attorney who defends physicians in malpractice cases.
Added Dr. Kenneth Peelle, president of the Massachusetts Medical Society, who supports Moore's legislation: "We think it's a different way of approaching some of the problems with malpractice claims than what we've been seeing in the last couple years."
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