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Happy Election Day! Remember to go out and vote for the candidates of your choice. Democracy is not a spectator sport!
THIS WEEK'S EDITION:
- Last week to register for Sorry Works! audio conference
- On the road again...
- Tone and tenor of these newsletters
- Question and Answer
- TORO - A Sorry Works! company?
Last week to register for Sorry Works! audio conference
This is the last week to register for the first-ever Sorry Works! audio conference. The conference is scheduled for a week from today, Tuesday, November 14th at 1pm EST. Remember, the conference counts for CME and CEU credits.
We have had a terrific response thus far, and have extended the registration through next Monday, November 13th at 5pm. To register, contact Melanie Gober at 517-886-8226 (phone), (517) 327- 4604 (fax), or e-mail: mgober@rmpsi.com.
If you have a scheduling conflict and cannot listen to the live audio conference, a CD of the audio conference can be purchased. Again, contact Melanie for the details.
On the road again...
Sorry Works! spokesperson Doug Wojcieszak will be hitting the road again this week to give three speeches over two days. On Thursday morning in New York City, Wojcieszak will be the keynote speaker at the Execusummit conference for med-mal insurers. Later that afternoon and also in New York City, he will be speaking to Physicians' Reciprocal Insurers. If you are interested in attending either speech in New York City, contact Rich Orbach at 800-905-9357 x 715 for the Execusummit meeting and/or Dawn Lewis for Physicians' Reciprocal Insurers at 516-365-6690 Ext. 453 or d.lewis@medmal.com.
On Friday morning, Wojcieszak will be speaking in Denver at the Colorado Patient Safety Coalition meeting...for registration information contact Lorraine Pickrell at 303-784-5761 or LPickrell@cfmc.org.
If you are interested in a Sorry Works! speaker, please contact doug@sorryworks.net or call 618-559-8168. Thank you!
Tone and tenor of these newsletters
Last week this newsletter contained a section on med-mal in Texas and made some pointed remarks on deny and defend, tort reform, and Sorry Works.
One of our loyal readers - who is a risk manager - reacted negatively to this section and shared concerns that the tone and tenor of some sections of this regular newsletter could be a turn off to some readers. She/he went onto say that many healthcare professionals in Texas and elsewhere - especially risk managers - embrace full disclosure and apology and the culture of healthcare has changed (witness the recently completed ASHRM meeting where disclosure was a major topic). He/she said doctors need to be encouraged to disclose and apologize, but if they feel like they are being berated they will simply "turn off." Finally, she/he concluded by saying that we at Sorry Works! need to focus on teaching doctors, and we should make a strong effort to get medical schools to teach disclosure.
First, the identity of this concerned reader is being kept confidential, which is our policy. Second, we truly appreciate his/her comments. This newsletter is an open forum and we will share thoughts and ideas from our readers, good and bad. We appreciate the feedback and encourage you to respond at doug@sorryworks.net.
Here's the response - Yes, there are many healthcare professionals who embrace Sorry Works! and are working hard to implement disclosure and apology programs. Yes, we are committed to teaching physicians about disclosure and are developing products for that purpose - i.e, the afore mentioned audio conference as well as train the train seminars. Yes, we need to get Sorry Works! into medical schools, and we need you, our readers to help with that. And, yes, the culture of healthcare is changing, but we still have a long way to go.
Deny and defend is still the rule of law in most healthcare and insurance organizations. Also, witness today - Election Day. How many doctors and healthcare professionals are working over time to get certain politicians elected in the name of fixing liability problems? Doctors want politicians to fix their problems, when, in fact, doctors can fix liability problems on their own, right now in a permanent fashion by simply focusing on patients and families. The solution is better customer service after adverse events, not political and legal "fixes." Sorry Works! provides the framework and program to do so.
So, how do you change the culture of medicine so that healthcare and insurance professionals view med-mal as a customer service problem? Some times the carrot, some times the stick. That's not just med-mal, that's life in general. When physicians turn their ethics on and off...when physicians turn their backs on patients and families....when doctors seek political solutions to customer service problems.....it needs to be called out, and there's not always a nice way to say it. Well-founded criticism can elicit change.
To our loyal readers who are sold on disclosure, we certainly don't want to offend or turn you off. These newsletters (and the website) are chocked full of information for all sorts of people. The new Q&A section is a great practical feature for all folks, especially the converted. We also try to include articles and stories each week (see below), and we also accept submissions from our readers. If a certain section turns you off, skip over it like you would a newspaper or magazine article, but please keep reading and forwarding this newsletter to colleagues and friends. Thanks!
Question and Answer
Welcome to this week's Q&A with Dr. Geri Amori, RM&PSI Senior Director (www.rmpsi.com) and former ASHRM president and Doug Wojcieszak, Founder and Spokesperson of The Sorry Works! Coalition (www.sorryworks.net).
Question: As a physician I support the philosophy and goals of Sorry Works, but how will risk management view the program?
Geri: Not all risk managers are the same, just as not all physicians are the same. There are a growing number of risk managers who view the Sorry Works! approach as both the right thing to do, and ultimately, although not quickly or easily, the best way to save money. The data is coming in supporting early resolution as cost saving over the long run, but it is risky to make yourself vulnerable. So, how do you approach this? First, talk with your risk management team. What do they think about apology and early resolution? What do they know about Sorry Works? What are their fears and concerns? You will need their support and the support of your insurance company to fully implement the Sorry Works! approach. You may work in an area where there is still the belief that patients just want to bilk the system and the only way to manage an error is to "deny and fight." Nothing stops you from doing the ethical thing in any situation. We will discuss how to approach this in another newsletter.
Doug: We at Sorry Works! have received some of the most positive responses (especially at live speeches) from risk managers. I think many risk managers "get it" when it comes to apology and disclosure. They understand patients and families and what really motivates them after adverse events(answers and accountability at the top of the list). Furthermore, risk managers are on the front lines and they catch the anger and hostility from patients and families when medical errors are covered up. So, when Sorry Works! comes along and says you can save money for the institution by quelling patient/family anger, that's a message that truly resonates with risk managers.
The question, however, strikes a deeper chord with me. Many healthcare and insurance professionals are starting to support disclosure and apology, what we call Sorry Works! However, they think they're alone. Docs believe the insurers and risk managers will never go for it. Insurers like the bottom line savings, but think the docs are too arrogant to apologize. Risk managers embrace Sorry Works! but are not so sure they can sell physicians, hospital adminstrators, and their insurance carrier on the program. What this shows is people need to communicate...if you believe in Sorry Works! and want to see it happen in your office, your hospital, your insurer, tell people! Communicate! Any hospital or insurer that started a disclosure and apology program can point back to a few committed people that were willing to carry the flag and get people excited. Be that person that makes the first step in your institution.
If you have a question, contact doug@sorryworks.net or gamori@rmpsi.com. Your identity will remain confidential. Thank you!
Toro - A Sorry Works! company?
Below is an article submitted by Dr. Barry Silbaugh, former President of the American College of Physician Executives. The number of similarities between the Toro approach illustrated in the story below and Sorry Works! are almost scary. Thanks, Barry!
Product Liability -- Pro-Active Protection
Toro attacks product liability, personal injury and property damage claims head-on -- and estimates savings at $13 million per year.
By Patricia Panchak
Nov. 1, 2005 -- While it seems every one else in the manufacturing community is wringing their hands over tort reform, the team over at The Toro Co., Minneapolis, is busy perfecting a 14-year-old program that's reduced the time and cost of resolving product liability, personal injury and property damage claims -- and has created some very happy customers in the process.
The strategy? The company quickly and privately closes two-thirds of the complaints and sends the rest to mediation. Ninety-five percent of the mediated cases are settled, leaving a small fraction of claims that go to trial -- and even those usually get settled on the courthouse steps, often for the amount proffered in mediation. Before the program was initiated, about half of the approximate 150 claims per year were actively litigated. This year, only three have proceeded beyond mediation to the more expensive litigation stage, but will likely "never see the courtroom," says Drew Byers, head of the program loosely dubbed the Mediation Program. The program has reduced the amount Toro spends on such claims, including fees and settlements, to $4.3 million a year, a 75% reduction from $17.3 million.
Another advantage: "We have not been in a courtroom since 1994," Byers says. "We have not had an officer or director of this company deposed or giving testimony of any kind in over 12 years." The time it takes to settle a claim, he adds, has fallen to nine months to a year, down from two to three years.
The program's philosophy is to treat the injured party as an unhappy customer, rather than as a potential litigant, and to act quickly. As soon as the team hears about an incident, a paralegal hustles out to talk to the customers involved, face-to face, taking an engineer along to inspect the Toro product. The goal is to investigate the incident and resolve the claim amicably. The paralegal is empowered to deny the claim outright, settle with a piece of equipment or cash, or turn the case over to mediation if an agreement is not reached. Byers stresses that the paralegals can settle even when there is no clear defect, but also when it could be perceived by the customer that there is a defect. Emphasis is on the personal, by letting the claimant state his case, Byers says. Many times the paralegal decides on the settlement by asking the claimants, "What would you like to see Toro do for you?"
The team of five -- Byers, two paralegals and an assistant in the U.S., and a representative in Europe -- gets a jump on claims by enlisting everyone in the company -- from production employees to sales territory representatives -- to be on the lookout for potential cases while they watch the local media. Everyone in the company gets a "Safety Watch" card, a triple-fold business- size card that lists the types of accident information to report. "It's got our work phones and our home phones, which gets them thinking in the right direction," Byers says. In addition, an engineer searches the Internet each Monday morning, trolling for incident reports that require investigation.
Fears that Toro will become an easy mark for frivolous lawsuits are unfounded, Byers says, because of the company's aggressive preparation for all mediated cases. "Once it goes into mediation mode, we basically prepare as if we're preparing for trial, and that word has gotten around," he says. Since the program started, only one potential litigant has tried to take advantage of Toro's penchant for quick resolution. A lawyer who had slipped and broken his ankle while mowing on wet grass, on a hill, claimed the mower pulled him off his feet. During the investigation, the lawyer admitted that he'd read an article about Toro's settlement approach and figured Toro would quickly pay his claim. Instead, Toro's representative denied the claim outright, implying that it was a perfect case to litigate, and "that was the end of that," says Byers. "We're not afraid to go to trial; we just choose not to. We're just trying to settle cases as quickly and as efficiently and as chea ply as possible. It's such a no-brainer for us. We've saved millions of dollars doing it, and we end up with a lot of very happy customers who tell their friends how well they've been treated."
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