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THIS WEEK'S EDITION:
- May 9th Audio Conference
- Progress in the Volunteer State
- Sorry Works! in Florida Newspaper
- Progress in North Carolina
- Nevada Apology Immunity Legislation
- News on Transparency/Disclosure in West Virginia
- Interested in Disclosure Training? We can help!
MAY 9TH AUDIO CONFERENCE - A DEEPER LOOK AT APOLOGY AND ITS ROLE IN DISCLOSURE
Plan to join us for the next Sorry Works! audio conference on May 9th from 1pm EST to 2:15pm EST. The title of the audio conference is "A Deeper Look At Apology and Its Role in Disclosure." As the title indicates, this conference will dig into the deeper issues of apology and disclosure and how the process impacts patients, families, and physicians. This is a "can't miss" conference.
Our featured speakers are Dr. Aaron Lazare and Dr. John Banja. Dr. Geri Amori of the Risk Management & Patient Safety Institute (RM&PSI) will be hosting and leading the conference call.
Dr. Lazare is the Chancellor of the UMASS Medical School and author of "On Apology," published by Oxford University Press in 2004. Dr. Lazare is an expert on apology and how it can harm or heal. He is a frequent speaker on apology to a wide variety of groups around the United States .
Dr. John Banja is a professor of bioethics at Emory University and the author of "Medical Errors and Medical Narcissism," published by Jones and Bartlett in 2005. Dr. Banja is also a frequent speaker on narcissism, medical errors, and disclosure before medical and insurance organizations around the United States .
Drs. Lazare and Banja will delving into the important issues surrounding effective and meaningful apology, and they will also be answering your questions live. Please join us for this important audio conference.
The audio conference counts for CME/CEU credits. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Risk Management and Patient Safety Institute (RM&PSI) and The Sorry Works! Coalition. RM&PSI is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. RM&PSI designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)TM. Application for 1.25 contact hours has been submitted to the Michigan Nurses Association, an accredited approver by the American Nurses Credentialing Center 's Commission on Accreditation.
The cost of the conference or CD is $225 (with a special rate of $150 for educational institutions and MHAIC/WCC insureds). Also, a special combo rate of $275 is available for both the live conference and CD. To register or for more information, please contact Melanie Gober at 517-886-8226.
PROGRESS IN VOLUNTEER STATE
We're starting to make great progress in the Volunteer State . Next week legislation will be introduced to develop Sorry Works! pilot programs in the State. Also, Sorry Works! spokesperson Doug Wojcieszak has been invited to speak before the TN Risk Managers in April and CHS Risk Management Conference in early May.
Tennessee is ripe for Sorry Works! - the state has experienced a nasty med-mal fight for several years, and hopefully doctors, lawyers, and insurance companies will be receptive to the middle- ground approach of Sorry Works! Stay tuned!
SORRY WORKS! IN FLORIDA NEWSPAPAPER
This past week Carrie Lavargna, a Florida attorney, published a positive column about Sorry Works! in the TCPalm newspaper. Thanks, Carrie! Read below.
Dear Doctor:Learn to say, 'I'm sorry'
By CARRIE LAVARGNA, correspondent
March 4, 2007
When my brother and I fought as kids, our parents would stop the argument and make us apologize. We learned to say, "I'm sorry."
A growing movement within the medical field is encouraging apologies and disclosures to reduce malpractice insurance premiums and improve patient safety.
Apology laws, as they are called, allow doctors to express sympathy and compassion after a patient is injured without fear that their words will be used against them in a civil suit.
Florida was one of the first states to pass an apology law. State law also requires hospitals to inform patients of incidents that caused serious harm. The disclosure is not to be used against the hospital in court.
Even though these laws are in place, Florida doctors and hospitals have not taken the lead in developing or implementing apology programs.
The public expects physicians to be honest and forthcoming, and the American Medical Association Code of Ethics requires disclosure when a significant medical complication results from a physician's mistake of judgment. Even so, only in about 30 percent of cases are medical mistakes disclosed to the patient, according to a 2002 report from the New England Journal of Medicine.
Last year, U.S. senators Hillary Clinton and Barack Obama proposed legislation to encourage disclosures. They argued that that the medical malpractice crisis should shift from placing blame to finding ways to improve patient safety.
Under their plan, if hospitals and physicians openly disclosed mistakes and implement procedures to prevent a recurrence of the problem that led to the patient's injury, then they would have protection from outlandish malpractice claims. At the same time, the patient who suffered injury or harm due to a medical error would be fairly compensated.
The most important factor in people's decision to file medical malpractice lawsuits is due to ineffective communication between doctor and patient, according to studies referred to by the senators.
Disclosure is the first element in effective communication. But without an apology, the patient's resentment and frustration does not go away. The patients are left to start a legal malpractice case to gain the information needed to determine what caused an unintended injury.
The vast majority of these lawsuits are dismissed or withdrawn with no monetary award for the patient, according to Doug Wojcieszak of The Sorry Works! Coalition, a group working to find middle ground on the medical malpractice crisis. Upfront disclosure and effective communication could prevent many cases from being pursued, says Wojcieszak.
The coalition has worked with numerous hospitals in Michigan, Indiana and Minnesota to reduce the number of medical malpractice claims and the money spent on lawsuits.
After the Veterans Administration hospital in Lexington, Ky., adopted a policy of full disclosure of medical errors with early offers of compensation, the hospital's liability costs fell well below those of comparable VA hospitals.
Why aren't Florida hospitals doing the same? It's time for Florida hospital administrators, doctors and their lawyers to recognize the power of saying, "I'm sorry."
This column is an overview of the subject matter and is not intended as legal advice. Carrie Lavargna is an attorney practicing law in Stuart.
PROGRESS IN NORTH CAROLINA
Last week Sorry Works! spokesperson Doug Wojcieszak presented to CNA- insured hospitals in Raleigh/Durham. The speech was well-received, and Wojcieszak will be heading back to North Carolina in late April to speak to the North Carolina Association for Healthcare Quality.
If you are interested in a Sorry Works! speaker, please contact doug@sorryworks.net or 618-559-8168. Thank you!
NEVADA APOLOGY IMMUNITY BILL
Apology immunity legislation continues to sweep the country - read below about a bill introduced by a Nevada Senator who is also a physician. All told, there are 29 states with apology immunity legislation, and several more states (Nebraska, Texas, North Dakota, South Dakota, Texas, Massachusetts, and now Utah) considering the idea.
zMar. 08, 2007
Las Vegas Review-Journal
Bill lets doctors speak freely
Proposal allows for apologies
By ANNETTE WELLS
REVIEW-JOURNAL
Words can't bring back Dianne Meyer's legs, nor her ability to do the jitterbug.
But when she awoke from a coma in November 2000 after seeking medical treatment at a local hospital for abdominal pain, some answers about why her legs were amputated and apologies from her health care providers might have eased some of the pain.
"We are all human beings, and we make mistakes,'' Meyer said Tuesday after learning of Senate Bill 174, which would allow Nevada physicians and health care providers to apologize or express sympathy for wrongdoing but not have that used against them in court.
The bill will be heard today by the Senate Judiciary Committee.
"When you wake up from a coma and have lost both of your legs, you want real answers. You don't want to have to fight to get them,'' said Meyer, who worked as an usher at Cirque du Soleil's "O" at the Bellagio before she went into septic shock and had to be hospitalized.
"But the only way to get the truth is to turn to an attorney," she said.
That is because lawyers for physicians will advise doctors not only to not apologize but not to say anything about a case once a patient alleges a mistake has been made.
"That's not to say I still wouldn't have sued," Meyer said, "but apologizing would have helped.''
Dr. Ronald Kline said physicians or health care providers are hesitant to offer even words of comfort if patients don't get better, even if the caretaker has done nothing wrong.
He recalled the case of a pediatric oncologist worried about offering sympathy to the parents of a child whose tumor had reappeared, because the doctor was afraid of how it would be interpreted.
Gerald Gillock, a Las Vegas attorney who handles medical malpractice cases for injured people, said the legislation is not important.
Gillock, who handled Meyer's claim, said too many other issues are on the state legislators' plates.
"If a doctor is guilty, or in his own mind is guilty, of medical malpractice, he doesn't apologize,'' Gillock said. "There is no sentiment to the family. Secondly, if a doctor has committed an act of malpractice and the case goes forward, the very last question I would ask is whether or not he or she apologized."
"Juries today are so biased and so in favor of the doctors," he said, they will use an apology as another reason to find against plaintiffs.
But Larry Matheis, executive director of the Nevada State Medical Association, said cases such as Meyer's are reasons for the bill: to bridge the communication gap between physicians and patients, especially during adverse medical events.
Another reason is to try to reduce the number of medical malpractice cases in Nevada.
"That's part of the problem with medicine today,'' Matheis said. "There is just this lack of communication between the patient and the physician, and because of this communication gap, we have physicians practicing defensive medicine -- ordering those extra tests out of fear they might miss something. This has paralyzed medicine. When something bad happens, no one talks.''
Patterned after similar legislation in 29 other states, Senate Bill 174 says that an expression of apology or regret made by health care providers is inadmissible in any civil or administrative proceeding brought against them.
Sen. Joe Heck, R-Henderson, an emergency room physician, said that should a physician apologize and try to rectify the problem by providing additional medical care, whatever information provided to the patient or family can be used against the physician.
Heck said he did not know whether the bill was going to be challenged. He said that in some other states, lawyers argued that such a bill might limit the ability for a patient to bring a lawsuit.
Bill Bradley, a Reno-based personal injury lawyer and member of the Nevada Trial Lawyers Association, said the organization does not have a position on the bill.
"We're...currently evaluating it to make sure that this bill holds the wrongdoers accountable and that victims of medical malpractice don't give up their rights,'' he said Tuesday afternoon.
Meyer, who reached a settlement with her health care provider out of court about two years ago, said she has no qualms with this bill if it does what it is intended to do: have doctors answer questions and provide help to those who are injured.
The 63-year-old lost her legs after she went into septic shock in November 2000. Septic shock is caused by an infection in the bloodstream.
Because of the conditions of her settlement, Meyer could not reveal whom she settled with or the amount of the settlement. According to District Court records, Meyer sued Summerlin Hospital Medical Center and a physician.
"Obviously, taking an apology from a doctor who has made an honest mistake is completely different from one who has shown complete negligence such as if they knew they made a mistake and waited hours before doing something about it,'' she said.
NEWS ON TRANSPARENCY AND DISCLOSURE IN WEST VIRGINIA
Below is an interesting article involving the Charleston Area (WV) Medical Center Health System, Inc. The article seems to focus on many issues that will be of interest to you, our readers.
Charleston Gazette
03/02/2007
Physician meetings must be open, court rules
Paul J. Nyden
West Virginia hospitals must now allow the public to attend formal meetings of physician committees at their facilities.
The state Supreme Court released a ruling Thursday that says the state's Open Hospital Proceedings Act applies to those meetings, as well as meetings of hospital board of trustees.
R.E. Hamrick Jr., a Charleston physician who filed the suit, stated he had been improperly denied access to meetings of CAMC's Medical Staff Executive Committee, which oversees the work of more than 600 physicians, divided into 14 departments, at local CAMC hospitals.
The ruling, written by Justice Larry Starcher, held that a hospital "governing body" is "not limited to a single, ultimate or 'top' decision-making body in a hospital's governance structure."
The Open Hospital Proceedings Act, passed in 1982, allows the public to attend hospital board proceedings "so that the people can remain informed of the decisions and decision-making processes affecting the health services on which they so vitally depend."
"CAMC disagrees with the court's decision," said hospital spokesman Dale Witte. "The governing body of CAMC is the Board of Trustees, and it complies with all open meetings laws."
"The Medical Staff Executive Committee is made up of physicians elected to represent their peers. All physicians on staff are welcome to attend the meetings. This case arose because of people wanting to bring their lawyers to the meetings."
Witte said the decisions of the executive committee are recommendations that must be decided by the board of trustees.
He said CAMC wanted the meetings closed to the public because sensitive issues are sometimes discussed at the meetings. "Peer review is one," he said.
Hamrick also won a favorable state Supreme Court ruling on Monday in another suit filed against CAMC. That ruling upheld his right to be self-insured for potential medical malpractice lawsuits.
Karen Miller, a lawyer and Hamrick's sister, handled both cases. Before Monday's decision was released, CAMC had adopted a policy allowing physicians to become self-insured.
In its response to Hamrick's second lawsuit, CAMC argued its Medical Staff Executive Committee was not a "governing body" as defined by the Open Hospital Proceedings Act.
"Although the quality of patient care is within the MSEC's jurisdiction, that jurisdiction is subject to the oversight of the governing body ' CAMC's Board of Trustees," the hospital stated in its legal brief filed in October.
Hamrick filed a legal brief in September, arguing his appeal of Kanawha County Judge James C. Stucky's ruling in favor of CAMC.
Hamrick and eight other heart surgeons associated with his appeal argued, "It is not only the public that is being shut out of these meetings. Even the doctors that practice at CAMC are regularly denied the right to attend these meetings or, on rare occasions, given limited time to speak."
Thursday's Supreme Court ruling also noted, "With respect to many issues, the deliberative and decision-making process at CAMC takes place at MSEC meetings. The MSEC at these meetings is therefore a 'governing body' for purposes of the Hospital Act...."
"A rigid, structural, 'single governing body' approach to the application of Open Meeting laws has been rejected in a number of similar cases" in several other states, the ruling added.
To contact staff writer Paul J. Nyden, use e-mail or call 348-5164.
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.
We recently 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!
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