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THIS WEEK'S EDITION:
- Texas Tech Medical School
- Pro-Mutual, CNA, PLICO will be hearing Sorry Works! presentations. We want more insurers to hear Sorry Works!
- Holy Names nurses - more news!
- The litigation guessing game: Volunteer Style
- Additional audio conferences
- Apology in Colorado
- Question & Answer
- Sorry Works! book coming - stay tuned
HAPPY NEW YEAR TO OUR READERS AND FRIENDS!!
TEXAS TECH MEDICAL SCHOOL
We closed out 2006 by speaking to the Texas Tech Medical School in El Paso, TX. The presentation was well-received and folks in the medical school are beginning the first steps of developing a disclosure program. We wish them luck and look forward to reporting on their progress.
At the conclusion of the presentation, Doug Wojcieszak, Sorry Works! spokesperson, received some good feedback from Dr. Antonio Jesurun of the Texas Tech staff. Dr. Jesurun encouraged Wojcieszak and Sorry Works! to focus more on teaching physicians how to actually apologize. Dr. Jesurun said the economic and ethical reasons for disclosure (which we really stress in our presentations) are becoming more and more apparent to healthcare and insurance professionals - but most doctors and healthcare professionals have no idea how to apologize. It's not taught in medical school! So, in 2007 more of our presentations will focus on the how to apologize. Thank you to Dr. Jesurun for his good feeback.
Final note: The Texas Tech presentation represented our fourth speaking engagement in the Lone Star State in the last 12 months (APMC Insurance in Dallas, Texas Medical Board, Baylor Medical Center, and Texas Tech). There are some other interesting developments afoot in Texas that we are involved in - just can't share them right now, but stay tuned. However, we want more and more progress in Texas. More speaking engagments, more meetings, more media coverage...please help us out! Thank you.
PRO-MUTUAL, CNA, PLICO WILL BE HEARING SORRY WORKS! PRESENTATIONS. WE WANT MORE INSURERS TO HEAR SORRY WORKS!
Pro-Mutual, CNA, and PLICO be hearing Sorry Works! presentations in the next couple months. Pro-Mutual executives will be hearing a Sorry Works! presentation in late January, while CNA insured hospitals in North Carolina and PLICO insureds will be hearing about Sorry Works! in March. Also, we have a 2nd speaking engagement with PLICO insureds in September.
We are making great progress with insurance companies, and we want to keep the positive momentum going. Please help us spread the word. If you work for an insurance company, suggest a Sorry Works! presentation to the powers that be. If you are physician or hospital executive, suggest a Sorry Works! presentation to your insurance company. Word-of-mouth publicity is critical to our continued success.
For more informaiton on Sorry Works! presentations, contact 618-559- 8168 or doug@sorryworks.net. Thanks!
HOLY NAME NURSES - MORE NEWS!
We sent out an extra newsletter immediately before Christmas about the nursing students at Holy Name Hospital in Teaneck, NJ and their Christmas tree covered with scarves for needy people. We received many positive responses from you, our readers, including Christina Orlovsky of Nursezone.com who penned a nice article about the special tree and future nurses (see below).
Hopefully other healthcare and insurance institutions will pick up on the Holy Name tradition.
Student Nurses Give the Gift of Warmth this Winter
By Christina Orlovsky, senior staff writer, nursezone.com
The holiday season at Holy Name Hospital, in Teaneck, New Jersey, is not unlike many hospitals across the country. Decorations adorn nursing units and the spirit of the season is in the air. One thing, however, stands out at Holy Name that's not often seen anywhere else: a tree decorated with knit scarves in place of ornaments.
Keeping in line with the Catholic facility's mission to serve the indigent in its community, students in the 130-student Holy Name Hospital School of Nursing make a commitment each year to community service projects. The scarf tree was one of the student organization's latest philanthropic creations.
"We always have a coat drive, where we donate coats and blankets, and we provide Thanksgiving dinner to needy families at the York Street Project in Jersey City, and then the students come up with their own projects, including the scarf tree," explained Susan Andrews, RN, MN, assistant director of the school of nursing. "Part of it comes from the school's outreach philosophy."
Another part of it, she added, comes from the students' desire to provide more than just medical care to the community they serve. Although the school has its own needs—more faculty, for one, and an expanded skills lab—the nursing students, who range in ages and education levels, are more attuned to the needs of those around them.
"I think the students become more exposed to their surroundings," Andrews explained. "They always knew this was going on in the community, but when they're dealing with the patients, they see the need more clearly. They're not in a financial position to donate money, so this is something they feel good about doing and something everyone can participate in."
Doug Wojcieszak, founder and spokesperson for the Sorry Works! Coalition, who was visiting Holy Name Hospital to give a presentation about his organization's medical error disclosure initiative, related his discovery of the scarf tree in his organization's latest newsletter:
"A staff member from the nursing school walked by, saw me looking at the tree, and in an almost apologetic voice said the tree was a project of the Holy Name nursing students. I told the staff member the tree was absolutely beautiful," Wojcieszak wrote. He closed his letter with his sentiments about the gift of giving— words that can be carried as a lesson for the season and beyond.
"No doubt many of you will scramble around this weekend to buy last minute presents and make preparations for the upcoming holidays," he said. "As you dash around please keep the Holy Name Christmas tree in mind—it's a great example of what the season is truly all about."
For more information, visit the Web site of Holy Name Hospital.
© 2006. AMN Healthcare, Inc. All Rights Reserved.
THE LITIGATION GUESSING GAME: VOLUNTEER STYLE
Read the article below...it's all about the litigation guessing game. What's the litigation guessing game? Well, it's an expensive game to play...it cost med-mal insurers in the Volunteer State $62 million to play the game in 2005. You could staff a cheap Major League Baseball team for that sum!
The litigation guessing game starts with an adverse event, then hospitals and doctors clam up, refuse to answers questions, and unhappy patients and families - customers - seek answer from trial lawyers.
Trial lawyers evaluate each case for merit and value, and if the case appears to have merit and is valuable enough, they will generally sue every provider on the chart and all institutions involved. Why? Because the trial lawyers are only getting half the story (the customer perspective)...no one from the hospital or insurer will talk to them. The trial lawyers literally have to guess, and they don't want the statutes to expire on any potentially legitimate claims so they sue everyone in sight with the thought that depositions and discovery will sort everything out. Often times numerous physicians are dropped from suits, but not until they've racked up sizeable defense bills. Other times, the cases get dropped entirely because it becomes apparent the standard of care was not breached. Remember, it's a guessing game! However, defense lawyers will rack up a large number of billable hours to reach this point.
The article below says some 83 percent of med-mal claims filed in the Volunteer State in 2005 were dismissed without compensation. Remember, it took $62 million to defend these claims. Of course, many folks in medicine, insurance, and politics will say this is an outrage. Frivolous lawsuits they will scream! But are these lawsuits really frivolous? What's frivolous about patients and families seeking answers and information that rightly belong to them? No, the only outrage here is when heatlhcare insitutitions and providers don't adequately communicate with patients and families after adverse events, whether there was an error or not. The medical and insurance communities can mostly blame themselves for this problem.
You must ask yourself how would the Tennessee numbers look if hospitals and providers in the state practiced Sorry Works? If they drew patients and families closer after adverse events, answered questions, compensated fairly for real errors while adequately explaining when an adverse events weren't caused by error? If they sent a strong, clear message to patients, families, and the trial bar: We will compensate fairly and quickly for real injuries but we will never settle non-meritorious claims? Imagine how the numbers would look!
Sorry Works! will be speaking to the Tennessee risk managers this April, and apparently Volunteer Mutual Insurance company is holding a program on disclosure and apology for their insured physicians this year too. Hopefully change is on the way in the Volunteer State.
Tennessean: Malpractice damages in '05 topped $119 million
Money was awarded in 16% of state claims
By SHEILA BURKE, Staff Writer
Sunday, 12/24/06
Most medical malpractice claims that closed in Tennessee last year resulted in no payment of damages to patients and their families, according to a recent report.
But the slightly more than 16 percent of claims paid accounted for more than $119 million in damages.
To doctors and others in the medical community, the report by the state Department of Commerce and Insurance shows it takes millions of dollars to defend malpractice cases, even if they ultimately go away.
Even in a successful defense, lawyers must be paid and investigations funded. That doesn't account for the higher medical costs incurred when doctors perform extra tests because they are afraid they will get sued.
Plaintiffs see other side
For the lawyers who represent patients and families claiming to be victims of egregious medical errors, the report shows something different: Assertions that runaway juries in Tennessee are awarding massive damages are a myth.
The report looked at the 2,827 medical malpractice claims that closed in 2005. Not every one of those claims would have resulted in a lawsuit.
"There are a number of ways claims can go away," said Steve Anderson, a Nashville lawyer who defends medical providers sued for malpractice.
The patient can drop the case. Or the patient may sue a number of health-care providers and drop the lawsuit against all but one or two, if information later reveals that only they are to blame for the malpractice.
If the claim results in a lawsuit, the judge can dismiss the case if the judge determine the suit is without merit, Anderson said.
2004 law spurred report
The report is part of the General Assembly's attempt to evaluate medical malpractice in Tennessee. In 2004, the legislature passed a law requiring the Department of Commerce and Insurance to issue annual reports on medical malpractice for the years 2005 though 2008, in hope of allowing lawmakers to spot trends.
The report doesn't track the number of lawsuits that resulted from claims filed, but next year the state will include that figure, said John Morris, deputy commissioner of Commerce and Insurance.
But the state's largest medical malpractice insurer offered a glimpse into the extent of malpractice litigation.
"We've had over 800 different doctors a year getting sued in Tennessee," said Steven C. Williams, president and chief executive officer of Brentwood-based State Volunteer Mutual Insurance Co. The doctor-owned company insures about 10,000 Tennessee physicians and 6,000 from surrounding states.
Of the 2,827 claims closed in 2005, 461 of them - a little more than 16 percent — were resolved through settlements, not jury verdicts. Slightly more than 83 percent of the claims closed resulted in no payout.
The cost of defending those claims was almost $62 million, the report said. The report also shows that of the claims closed in 2005, five resulted in jury verdicts for the plaintiffs, with the judgments totaling a little more than $6 million.
Lawyer points at 'myth'
Brentwood lawyer John Day, who represents patients and their families in medical malpractice cases, says that figure shows illustrates the myth of juries awarding outrageously high damages.
A Nashville jury awarded a West Tennessee family $16 million in 2005 after a doctor accidentally cut out 90 percent of a child's bladder during a surgery. A judge knocked the judgment down to $6 million and the state Court of Appeals recently upheld the judge's decision.
That case was not captured in the report, presumably because the case is still being appealed. Morris, of the Department of Commerce and Insurance, said only amounts paid in 2005 were included in the report.
The fact that a judge knocked down the award to $6.5 million means the system works, said Day, the plaintiffs' lawyer.
He pointed out that in 2004 the damages paid were even lower. Six juries in the state awarded damages totaling $1.9 million.
How many times the health-care providers win when they get in front of a jury will be included in future reports. So will the amount of money that patients' lawyers make off the malpractice cases.
Anderson, who defends health-care providers, said it is the unusual case that actually gets in front of a jury, because bad cases get settled before trial.
The "defendant and the defendant's counsel evaluates those cases that they think are dangerous and difficult and those are usually settled," he said.
ADDITIONAL AUDIO CONFERENCES
Additional Sorry Works! audio conferences are being planned in 2007, with the first one later this April or May. Stay tuned for details and please help us spread the word about these valuable teaching tools.
CDs of the first Sorry Works! audio conference which was held two months ago can be ordered by contacting Melanie Gober at mgober@rmpsi.com or call 517-886-8226. The Sorry Works! audio conference can count for CME and CEU credits for two (2) full-years after the conference date (November 14, 2006).
APOLOGY IN COLORADO
Below is a recent news story on med-mal insurance rates stabilizing and declining in Colorado. Notice the bolded/underlined section where insurers give most of the credit to apology and disclosure.
Some doctors get break on insurance
State's malpractice rates, flat in 2006, to decline in 2007
By Bill Scanlon, Rocky Mountain News
November 29, 2006
Overall malpractice insurance premiums for Colorado's doctors are flat or declining slightly. After years of skyrocketing premiums - neurosurgeons were paying $71,000 a year, emergency-room doctors $18,000 - the rates went up just about 2.9 percent for 2006.
Tuesday, the Doctor's Co., a liability insurer that is the second- biggest in Colorado, announced its rates will drop on average of 6.7 percent for 2007.
And COPIC, which insures four out of five Colorado doctors, said the average doctor will see no increase for 2007, although some specialties will see small increases and others will see small decreases.
Insurers credit two recent laws passed by the state legislature. One limits the amount of punitive damages for things such as disfigurement to a maximum of $300,000. It still allows full compensation for medical bills and time missed from work.
The other law is probably more important, say insurance companies. It allows doctors to sit down with family members and explain what went wrong.
That face-to-face open communication is important to families, and more often than not it rids them of the desire to sue, they say.
COPIC also has come up with another approach that has proven successful, said legislative consultant George Dikeou. He echoes the importance of doctors and family members talking together. "There is a need for the physician and patient to communicate clearly with one another, to defuse miscommunication or confusion that can escalate a situation no one intended."
Cathy Lindquist-Kleisser is executive director of the Denver Medical Society, which has 1,600 members, many of whom are insured by the physician-owned Doctor's Co.
She credits the drop in premiums to doctors "working very hard to make sure they are providing quality care to patients," as well as to the laws passed by the Colorado legislature.
While the savings might not be passed on directly to consumers, "keeping the price of providing medical care as low as possible translates into making it more affordable. And it does increase access."
The cost of practicing medicine
Average malpractice increases in Colorado:
2001 2.7 percent
2002 6.7 percent
2003 14.2 percent
2004 13.8 percent
2005 15.9 percent
2006 2.9 percent
2007 -6.7 percent*
* Estimate
Sources: Copic Insurance Co., The Doctor's Co.
scanlon@RockyMountainNews.com or 303-442-8729
QUESTION & ANSWER
QUESTION/CHALLENGE: "Well, how much money do trial lawyers make off Sorry Works! What does the trial bar think about Sorry Works?"
Doug: Who cares!? Medical and insurance professionals need to stop fixating on the trial bar and focus instead on patients and families. Take care of your customers and your other problems – including the trial bar – will become non-issues over time. Remember, the med-mal crisis is a customer service problem, not a litigation issue!
Trial lawyers have mixed reactions to Sorry Works! Trial lawyers have had their heads bashed in by medical and insurance interests over the years, so many are naturally suspicious of any program like Sorry Works! that appears to benefit medicine and insurance. However, the institutions that conduct disclosure report over time that trial lawyers like working with disclosure programs. Disclosure allows trial lawyers to be involved in smaller cases they normally couldn't afford to prosecute under deny and defend. Furthermore, Sorry Works! helps cull out weak and non-meritorious cases that would cost a lot to prosecute and most likely yield no return. (Non-meritorious cases includes instances where only one physician was at fault for an incident and all the other providers on the chart had no fault in the harm-causing error). Furthermore, many trial lawyers say their clients often want more than zeros on a check - they want answers, accountability, and a pledge to make medicine better so the mistakes don't happen again. Sorry Works! fulfills these wishes better than traditional litigation.
Finally, there may be some overzealous members of the trial bar who don't like the program. Again, who cares? The most aggressive trial lawyer is powerless without an angry customer calling them.
Geri: This is a great question! In my experience, the answer is "Not enough for their taste!" Lawyers seem to have mixed reactions depending a great deal on their interests. For some lawyers, a Sorry Works! approach is disappointing.....plaintiffs seek less money or are willing to negotiate when they are less angry. This translates into less money for their attorney. Attorneys who are committed to fixing the system and who want to help clients heal quicker psychologically appreciate the approach. Those who want the drawn out fight in hopes of getting more money (and I've personally HEARD a few say that) don't like it. On the other hand, it works the same way for defense attorneys. Some who feel that the "insurance" money used to pay them for defending a case is separate from the overall cost of the case, and who feel that "defending from indemnity" is the essential goal and may not realize that this method inhibits learning that improves care, don't like the approach at all. I have friends and acquaintances who have said "I don't want to settle or resolve this. I get paid on billable hours!" I also know attorneys who say something on the order of: "The Sorry Works! approach is like being paid in increments." There are small chunks that come from supporting early resolution. They are good because you also know that the hospital is making steps to prevent that error from occuring again. When there is no error, however, you have a case to defend vigorously that you can defend with your whole heart.
Does the trial bar like the Sorry Works approach? Why would they? It disruptes the system by which they make money. Those attorneys who care about improving healthcare nonetheless, are willing to examine other ways to approach the issues that lead to anger and litigation.
SORRY WORKS! BOOK COMING - STAY TUNED!
The Sorry Works! book will be hitting the streets later this spring - stay tuned!
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