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THIS WEEK'S EDITION:
- Interested in disclosure training? We can help!
- Response to Health Affairs e-blast/Harvard study
- Moving past courts and torts conference in PA
- Comments from CBS story
INTERESTED IN DISCLOSURE TRAINING? WE CAN HELP!
Disclosure is a very hot topic today. Many health care and insurance organizations are beginning to understand the ecomomic and social benefits of disclosure for patients, patients' families, as well as their medical staff and insureds. The million dollar question is, "How can we implement disclosure into our organization?" We can help.
Last week we announced a strategic partnership with Stevens & Lee, one of America 's premier health care professional liability defense and risk management firms, to provide disclosure training and teaching materials for health care, insurance and legal professionals. We are excited about this partnership because it will help such professionals overcome one of the biggest stumbling blocks to implementing disclosure - concerns from legal, risk management and claims. Stevens & Lee's health care attorneys are experienced in defending doctors and hospitals and will work with Sorry Works! to help physicians and their staff get past the barriers they face and implement disclosure the right way.
Stevens & Lee's Health Care Litigation and Risk Management practice is led by James W. Saxton, Esquire. Jim and his team of experienced attorneys and risk management consultants understand how hospitals, doctors, patients, patients' families and plaintiffs' attorneys operate. They know that disclosure and apology done in the right way can greatly reduce litigation and associated expenses. They have the knowledge, experience and credibility to help institutions implement successful disclosure programs which can lead to professional liability risk reduction.
If you are interested in disclosure training, copy and paste this link - http://www.sorryworks.net/questionnaire.phtml - into your browser. The link will direct you to a few short questions, click submit, and information on disclosure training opportunities will be sent to you shortly. Thank you!
RESPONSE TO HEALTH AFFAIRS E-BLAST/HARVARD STUDY
A few weeks ago in this newsletter we responded to the Harvard study on disclosure published in Health Affairs. Yesterday, Health Affairs distributed an e-mail blast with the Harvard study included, and it raised some questions among our readers. So, we thought it wise to re-publish our response. See directly below...thank you!
SORRY WORKS! RESPONSE TO HARVARD DISCLOSURE STUDY
The journal Health Affairs recently published a study on disclosure and its potential cost impacts by five Harvard researchers (Studdert et. al; January/February edition). We applaud attempts to better understand and research disclosure. The authors take many novel approaches to attempt to quantify the total systematic cost of claims if all healthcare institutions conducted disclosure. They surveyed numerous experts (attorneys, physicians, risk mangers, insurance professionals, etc) on the potential value of claims and then fed these results into a computer model. Surprisingly, the model said overall claims would cost more with disclosure, not less. Why the difference between the model and the numerous institutions and organizations reporting reduced litigation and cost savings with disclosure? The answer can be found in the methodology used by the Harvard researchers.
The real experts are not medical, insurance, and legal professionals in a simulated study but the patients and families who have actually experienced adverse medical events. Unfortunately, not even the most gifted researcher can replicate the positive emotional impact of disclosure on patients and families and how those feelings influence financial decisions and litigation. If this sounds "touchy feely" it is, because in the words of Sorry Works! board member Dr. John Banja disclosure "is all about the feelings." By constructively addressing feelings after adverse events, disclosure mitigates anger among patients and families and the urge to financially punish doctors, hospitals and insurers. This "touchy feely stuff" is the reason that disclosure reduces lawsuits and settlement costs.
Yes, claims (not lawsuits) may increase with disclosure, as the Harvard researchers suggested in their study. However, it appears that the Harvard researchers operate in the typical mind frame that medical malpractice is "all about the money." When institutions conduct disclosure, money becomes a secondary or tertiary issue, as it should be. Disclosure acknowledges the humanity of patients and families, which mitigates anger, and when anger is off the table people can become very reasonable and creative about what constitutes fair compensation. Yes, sometimes checks - even big checks - will have to be written to pay for the damage caused by medical errors, but they're not "jackpots" because patients and families are not trying to punish the institution. Furthermore, there are plenty of stories coming from disclosure institutions where patients and families have had - for example - patient safety lectures or wings of hospitals named after loved ones. There are also plenty of incidents where compensation was rejected completely by patients and families simply because the "sorry" was good enough.
Simply assuming that every disclosure event will result in a claim where significant sums of cash are paid - as the Harvard researchers did - is a bad assumption and shows a total lack of understanding of what truly motivates patients and families after adverse medical events.
Furthermore, the Harvard researchers did not quantify the reduction in litigation expenses for meritorious claims as well as the decrease in non-meritorious litigation with disclosure. Across the med-mal industry, seventy to eighty percent of claims are closed with no compensation being paid. These are major costs factors that are a real drag on the med-mal industry with traditional deny-and- defend risk management strategies - and disclosure's ability to rein in these costs is one of the big selling points for institutions considering Sorry Works!
Given all reasons above, the only feasible way to measure the financial impact of disclosure is to directly study institutions conducting disclosure. However, this was the most surprising facet of the study: The authors did not study real-world institutions conducting disclosure! There are many institutions that are reporting positive experiences for their bottom line with formal and informal disclosure programs (most notably the University of Michigan), but the authors simply did not contact or study these organizations. Surprising and disappointing.
Future studies should more closely study the phenomenon of disclosure and apology in medical and insurance organizations that are actually operating disclosure programs. However, please understand: Institutions that embrace disclosure and apology undergo massive culture changes with numerous tangible and intangible financial benefits. It will be difficult if not impossible to measure the financial and other benefits of disclosure in a computer model. Instead, researchers interested in future studies on disclosure will need to engage in the painstaking efforts of observing and understanding organizations conducting disclosure. We look forward to such efforts.
MOVING PAST COURTS AND TORTS CONFERENCE IN PA
Below is an encouraging sign in the Keystone State . As many of you know, Pennsylvania has been the site of a truly bloody battle between physicians, lawyers, consumers, and insurance companies over the medical malpractice crisis. Perhaps that fight is cooling and folks are looking for alternatives. Read below.
Moving Past Courts and Torts conference to discuss alternatives to the current medical liability system, better ways for patients and providers to resolve disputes
How can patient injuries be better resolved—and liability proceedings averted—through disclosure of medical errors, apologies, and mediation?
That will be the big question put before "Moving Past Courts and Torts: A conversation to find a better way for patients and providers to resolve disputes" - a conference hosted by the Pennsylvania Medical Society - on Thursday, March 22, 2007, at the Hilton Hotel in Harrisburg.
Physician leaders of medical staffs, medical practices, and county and specialty societies will gather along with hospital administrators, practice managers, government representatives, and other lay persons to hear several top speakers on alternatives to the current medical liability system.
The conference will help shape the State Society's services and advocacy on medical liability alternatives.
Online registration is available on our Web site store
For more information, contact Cheryl Fultz at cfultz@pamedsoc.org or (800) 228-7823, ext. 1409.
RESPONDING TO COMMENTS FROM CBS STORY
Two weeks ago CBS News ran a nice story on Sorry Works! and apology & disclosure in medicine. Some viewers commented on the CBS website, and we wanted to share these comments with you and our response. These comments are typical rebuttals we deal with every day, and we thought you, our readers, would like to know how to handle these questions too.
Question/Challenge: An apology is a good way for the medical profession to start acknowledging errors, but "I'm sory" does not go far enough. If doctors want to cut down on lawsuits, there must be a way -- other than suing -- to compensate people injured by doctors for their out-of-pocket expenses. From personal experience, I know those costs can run into the thousands. That's the dirty little secret of being injured by a doctor. If you're not dead or disabled, the bills are all yours.
Answer: Sorry Works! is much more than "sorry." If a medical error occured, an apology is offered along with an admission of fault, explanation of what happened and steps to prevent it from happening again, and an offer of fair, upfront compensation. For apology to be truly effective, these four elements must be present. Apology without compensation will be viewed as meaningless and hollow.
Challenge: Due to the fact that there are over 1,000,000 lawyers in America, I doubt that "I'm sorry" is going to replace "Here come the plaintiffs."
Answer: This challenge is rooted in the typical dialogue of the med-mal debate, chiefly that greed drives med-mal lawsuits and lawyers are to blame. First, anger, not greed, is what drives most med-mal lawsuits. Ask any defense attorney or risk manager. Patients and families become angry when adverse medical events are covered up. Second, the most powerful plaintiffs' attorney is powerless without an angry patient or family calling him/her.
The chief thesis of The Sorry Works! Coalition is that the med-mal crisis is a customer service crisis that has been miscast as a legal problem to be solved by politicians. Another way of saying it, the med-mal crisis is a customer service crisis that medical and insurance professionals can fix anytime they wish. When adverse medical events are handled with excellent customer service, patients and families are much less likely to become angry, and the chances of litigation being pursued drop accordingly.
To view the CBS story, visit this link.
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