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"Deny and defend" is as scary as Halloween. Don't be a Ghoul - disclose to your patients and families! Happy Halloween to our loyal readers.....we appreciate you and your help spreading the word about disclosure and apology.
IN THIS EDITION:
- JCAHO Journal article
- High marks at Crittenden's conference
- Stepping onto the international stage
- Cleveland Plain Dealer article
- Dr. Robert Good
JCAHO Journal article
This week the June 2006 edition of the Joint Commission Journal on Quality and Patient Safety was released with a forum article on Sorry Works! If you want to provide information on Sorry Works! to your colleagues, this is a great article to share (along with the Cleveland Plain Dealer article below). The article includes much information on the Sorry Works! process and rebuts common criticisms.
Here is a link with a summary of the JCAHO article with purchase options. Also, we've been informed that JCAHO will be posting the article on the Joint Commission and the Joint Commission International Center for Patient Safety websites. Many thanks to Dr. Paul Schyve and Steve Berman for their help and hard work on this important article.
High marks at Crittenden's conference
The reviews are in, and the Sorry Works! talk was the second highest rated presentation at the recently completely Crittenden's meeting in Phoenix, Arizona. The Sorry Works! team included Steve Day, med- mal defense attorney from Pennsylvania, and Doug Wojcieszak, spokesperson for the coalition. Thanks to all of our new friends who gave us high marks.
Interested in a Sorry Works! presentation for your healthcare, insurance, or legal organization? Write doug@sorryworks.net or call Doug Wojcieszak at 618-559-8168.
Stepping onto the international stage
This week, Sorry Works! was invited "down under" to speak before the Australasian Society of Cataract & Refractive Surgeons in July. Also, there is some initial interest in forming a European chapter of Sorry Works! If you are interested in joining our efforts to form a board of directors in Europe, please send an e-mail to doug@sorryworks.net.
Of course, we continue to work back home in the states too. Next week, we will be presenting before MacNeal hospital in Chicago, and in June we will be speaking before the New Jersey Medical Liability Task Force and New York State Neuroligical Society.
Cleveland Plain Dealer article
Doctors starting to say 'I'm sorry'
Duck, deny may not be best way to avoid suits
Monday, May 15, 2006
Harlan Spector
Plain Dealer Reporter
It turns out that never having to say you're sorry is not good for love - or medicine.
In the case of love, the divorce rate peaked after the sappy 1970 movie "Love Story" proclaimed that apology is uncalled for between sweethearts. As for medicine - where the standard response to blunders has been to duck and deny - well, you've heard about the malpractice liability crisis?
Some forward-thinkers in health care are changing the deeply entrenched policy of admitting no wrong.
With the blessings of hospital risk managers and a push from a group called the Sorry Works! Coalition, doctors are increasingly reaching out to patients and families to explain medical errors and apologize for them.
The era of full disclosure is in its infancy, but already advocates tout promising results. The University of Michigan Health System began acknowledging harmful mistakes and offering compensation to injured patients in 2001. The health system reported that the new policy saved $2.2 million a year in litigation costs. The Veterans Health Administration also has adopted a disclosure policy.
"I've observed that patients are willing to forgive," said Joseph Feltes, a Canton lawyer who represents several hospitals. "But you've got to be upfront with people."
Medical errors kill as many as 98,000 people a year in the United States, according to a groundbreaking 1999 report from the Institute of Medicine.
Experts say medical mistakes don't trigger most malpractice suits, but rather anger over being spurned by caregivers after something goes wrong.
As many as 80 percent of malpractice claims arise from communication breakdowns, according to a recent article in Patient Safety and Quality Healthcare, an online publication.
Feltes tells a story of a widow who sued her late husband's doctor for malpractice and refused reasonable settlement offers. Asked by a judge why she refused to settle, the woman said she was angry that her husband's longtime physician never spoke to the family or apologized after the death.
Michele McBride of Lyndhurst said her family might not have filed suit in 2003 if a doctor had come clean after her 22-year-old sister, Shannon, bled to death following a tonsillectomy. The family lost the case at trial in Lake County Common Pleas Court.
"No one ever sat down with me or my family and said, 'This is what happened to Shannon,'" said McBride, 32, who last year formed a consumer group with another sister called Patient Safety Cleveland. "You have this doctor, this nurse who help you through your entire stay at the hospital. But if something goes wrong, you're cut off."
Advocates say full disclosure not only improves the litigation climate but also encourages better safety practices.
University Hospitals Health System has a policy that encourages full disclosure of medical errors, spokeswoman Loree Vick said. The Cleveland Clinic Health System has no formal policy but educates its physicians about the importance of being forthcoming with patients about complications or outcomes that fall short of patient expectations, spokeswoman Eileen Sheil wrote in an e-mail.
Many states wrestling with tort reform have passed laws that shield doctors from legal liability for apologies. Ohio passed such a measure in 2004. But state law does not protect a doctor's admission of error, which some say is a stumbling block to full disclosure.
Dr. Lloyd Jacobs, president of the Medical University of Ohio in Toledo, told the Ohio Medical Malpractice Commission in 2004 that the "punishing" atmosphere of the state legal system made openness difficult to achieve.
Ohio's insurance director, Ann Womer Benjamin, who chaired the commission, said in an interview that doctors are concerned about potential liability being attributed to them for any discussion.
"We have a state where the litigation system is strong; trial lawyers are a strong voice and do not want to impede a person's ability to go to court and file a claim," she said.
Ultimately, though, the acceptance of open disclosure may rest more with doctors than lawyers and legislators. It starts with medical schools, which are traditionally weak on teaching communication skills, Jacobs said.
Changing the duck-and-deny culture may take decades, he said.
"Those people over 45 years old are skeptical," Jacobs said. "Those under 35 years of age are enthusiastic."
For more information, visit the Sorry Works! Coalition at www.sorryworks.net and Patient Safety Cleveland at www.patientsafetycle.bravehost.com
To reach this Plain Dealer Reporter:
hspector@plaind.com, 216-999-4543
Dr. Robert Good - closing thoughts
This week one of our friends provided a daily devotional on the late cancer researcher Dr. Robert Good. To summarize, the devotional said Dr. Good was quick and eager to recognize errors in his theories and abandon them faster than anyone else in medical research. The article went onto say that Proverbs 9 puts a high premium on such a willingness to see one's error and admit it. It describes a wise man (or woman!) as one who wants to learn from his mistakes. To quote from the devotional: "When challenged, he resists the urge to get his back up like a threatened tomcat. Instead, correction becomes a faithful friend and a necessary means to improvement (v.9). On the other hand, when a "scoffer" is rebuked, he responds with anger and hate (v.8). Because of his overinflated ego, he won't listen when told he has erred."
Words of wisdom from Dr. Good, Proverbs 9, and this devotional - definitely worth sharing with colleagues and friends.
Have a happy and safe Memorial Day weekend from your friends at Sorry Works!
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