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THIS WEEK'S EDITION:
- Sorry Works! newsletters - A Monday afternoon affair. Book it!
- Sorry Works! webinars in May, June, & July
- Focus on Ilinois: Docs' legislative "victories" eroding quickly...time to think anew
- Sorry Works! speaking to Canadian Ombudsman
- Reminder: Joint Commission Resources Meeting on Disclosure in June
- Patient responds to Iowa Study on Physician Disclosure After Medical Errors
- News Article on Iowa Study
SORRY WORKS! NEWSLETTERS - A MONDAY AFTERNOON AFFAIR. BOOK IT!
Due to a hectic travel schedules, the Sorry Works! newsletter has bounced around during the week. We apologize to you, our readers, for the inconsistencies. However, you can now "book" a date with Sorry Works! every Monday afternoon (except next week for the Memorial Day Holiday, when Sorry Works! will appear on Tuesday). We hope Sorry Works! will brigthen your Monday afternoons and help you get the week off on the right foot with the latest on the disclosure and apology movement. Many thanks to our loyal readers and friends.
SORRY WORKS! WEBINARS
Starting on May 30th and running through mid-July, Sorry Works! founder and spokesperson Doug Wojcieszak will holding weekly webinars to discuss various aspects of the disclosure and apology movement. To tune in visit this link for dates, times, and registration information. Thank you!
FOCUS ON ILLINOIS : DOCS' LEGISLATIVE "VICTORIES" ERODING QUICKLY...TIME TO THINK ANEW
Like so many states around the nation, Illinois has seen a pitted battles over the last four years between physicians and lawyers. At the behest of the Illinois State Medical Society, ISMIE (the Illinois bed-pan mutual), the AMA and varoius tort reform allied, Illinois physicians donated truckloads of money and their time to fight for various reforms. In 2004 and 2005, Illinois docs claimed victories by electing a Republican to the Illinois Supreme Court from a traditionally Democratic district and passing $500K caps through the Democratically-controlled legsilature and Governor's office. But those victories are now starting to be wittled away.
Last fall, all of the lower court judges appointed by the Republican Supreme Court justice were soundly defeated at the ballot box. Furthermore, one piece of legislation to get around the caps is moving through the legislature. Finally, the caps bill is under constitutional review and will likely be overturned (for a third time in Illinois history!).
Hopefully these episodes provide a strong lesson for Illinois physicians and their colleagues around the United States (and the world!) There is only certainty with politics: You'll be dissapointed 99 percent of the time! If physicians truly want to solve the med-mal crisis, they need to stop focusing on politicians, lobbyists, elections, and even lawyers, judges, and juries. There are no certainties in that arena. Instead, they need to focus on patients and families...their customers. The literature has told us countless times that the vast majority of med-mal lawsuits are filed out of angry because of service laspes after adverse events - not because of money or greed!
The main thesis of The Sorry Works! Coalition is that the med-mal crisis is a customer service that has been miscast as a legal problem to be solved by politicians. Another way of saying, the med- mal crisis is a customer service crisis that can be solved by medical professionals anytime they wish.
When medical professionals start addressing the med-mal crisis in a customer service context, they will not only discover the problem can be solved on their own very quickly, but also no one can ever take away those solutions. That's very empowering versus the frustration and empty promises on display in the news article below:
Illinois lawmakers back damage awards for grief
By Kevin McDermott
ST. LOUIS POST-DISPATCH SPRINGFIELD BUREAU
Friday, May. 18 2007
SPRINGFIELD, Ill. Illinois lawmakers on Thursday passed a measure that lets jurors consider the grief and sorrow of survivors when deciding payouts in wrongful death lawsuits — a move that promises to reopen political wounds from the state's medical malpractice battle of two years ago.
Gov. Rod Blagojevich, a Democrat, hasn't said whether he will sign the bill, which passed the Senate Thursday 31-23.
Illinois now allows jurors to consider several factors when deciding how much to award plaintiffs who prevail in wrongful death suits. Factors include actual damages such as loss of income, as well as "noneconomic" damages such as the loss of love, comfort and other intangibles by the survivor- plaintiffs.
The new legislation would add heartache to that list of intangibles, allowing jurors to consider "damages for grief, sorrow, and mental suffering, to the surviving spouse and next of kin of such deceased person."
That language, the result of a lobbying effort by Illinois trial lawyers, reopens a fractious debate over what doctors and hospitals should have to pay when their patients are maimed or killed. In 2005, Illinois capped the amount that plaintiffs could collect for noneconomic damages in malpractice cases, to $500,000 per doctor and $1 million per hospital.
That change in the law — which was fiercely opposed by trial lawyers and is now being challenged in court — was prompted by alleged doctor shortages in the Metro East and Southern Illinois .
Proponents of the new legislation point out that it doesn't change the current caps on noneconomic damages but rather opens up a new avenue to pursue those damages.
"We're very glad the General Assembly has decided to join other states in fairly compensating people for grief and sorrow," said Judy Cates, a Swansea attorney and president of the Illinois Trial Lawyers Association. "It's about time."
Opponents say the change could prompt juries to go right up to the top award limits in more cases — and could lead to a rash of astronomical awards if those limits are eventually removed by the courts.
"Current law already provides for proper recovery in wrongful death cases," Dr. Rodney Osborn, a Peoria anesthesiologist and president of the Illinois Medical Society, said in a written statement. "This legislation is clearly a disguised grab for cash by the plaintiff lawyers."
Supporters of the legislation say that allowing compensation for the grief of survivors is different from the current allowable compensation for the loss of love and comfort. Critics say there is no difference, and that the legislation would allow juries to double-count emotional impact when determining the amount to award to plaintiffs.
The lingering bitterness of the statewide policy battle of two years ago was evident in Senate floor debate Thursday.
"I guess many of you feel some type of payback is necessary to the trial lawyers, since we had to do something (in 2005) to keep physicians from leaving Illinois ," said state Sen. Kirk Dillard, R-Hinsdale. He characterized the bill as bad and said, "it allows for double-recovery."
Dillard said the bill "will leave access to medical care, especially in rural Illinois , floundering in the wind again."
The bills sponsor, Sen. Kwame Raoul, D-Chicago, countered that grief is a legitimate factor in deciding jury awards. "If a drunk driver runs over your child, you want to be able to talk about the grief and sorrow and mental anguish" in the civil suit, Raoul said.
Thursday's Senate vote - like the earlier House passage of the bill - was mostly along party lines, with majority Democrats generally in favor of it.
Among exceptions have been a few downstate Democrats who either opposed the bill or abstained from the vote.
"I was being pulled both ways, so I just didn't vote on it," said Sen. Gary Forby, D-Benton.
Blagojevich, an attorney who has been closely allied with trial attorney organizations, hasn't decided whether to sign the legislation, a spokesman said Thursday. Blagojevich was a reluctant signer of the litigation caps measure in 2005, saying at the time that he personally opposed the concept.
The bill now on his desk is HB1798.
Adam Jadhav of the Post-Dispatch staff contributed to this report. kmcdermott@post-dispatch.com; 217-782-4912
SORRY WORKS! SPEAKING TO CANADIAN OMBUDSMAN
Next Monday Sorry Works! spokesperson Doug Wojcieszak will be spending Memorial Day north of the border in Montreal speaking to the Canadian Ombudsman about disclosure and apology.
To see a list of hospitals, insurers, and organziations we've spoken to, visit this link or for more information e-mail doug@sorryworks.net or call 618-559-8168. Thank you!
REMINDER: JOINT COMMISSION RESOURCES MEETING ON DISCLOSURE IN JUNE
Joint Commission Resources is holding a two-day conference on disclosure with many of the nation's leaders on the topic, including several Sorry Works! board members. This will be a fantastic meeting. Dr. Michael Woods, Dr. Albert Wu, Dr. Steve Kraman, Dr. Lucian Leape, Rick Boothman (from Univ. of Michigan), Linda Kenney, Marty Hatlie, Dr. Rich Quinn of COPIC, Doug Wojcieszak, and many others will be there.
For more information, please paste this link into your browser: http://www.jcrinc.com/23681/ .
PATIENT RESPONDS TO IOWA STUDY ON PHYSICIAN DISCLOSURE AFTER MEDICAL ERRORS
In last week's newsletter we shared information with you on a University of Iowa study on physicians' attitudes towards disclosure, and how those attitudes scare with reality (i.e, docs say they believe in disclosure, but few actually practice, especially after major adverse events). This week we share with you a patient's perspective on that study as well as a recent new article (see next). Below are the patient's comments, unedited:
I have a comment for the Iowa study on disclosure where it states that:
"Creating such circumstances requires concerted efforts to build a culture of learning and healing that supports the physician's self- identity as a healer, at a time when it may be threatened, and promotes the dignity and well being of the patient after he or she has been harmed."
Comments:
1. Hiding an error from the patient does not support the physician's self-identity as a healer because it has great potential to harm the patient if in fact it does not. A healer does not harm, but accidents do happen.
2. From a patient's perspective (my own) it definitely would reassure me that my Doc was going to stick around and fix the error which would make me feel cared for, and in return the physician's self-identity as a healer would stay in tact.
3. The threat to the Doc's self-identity as a healer appears to arise when disclosure is not provided and all the patients dignity and well being has been lost -- often times with the patient having no where to turn.
4. The healer runs away which causes their own threat to their own self-image. Unfortunately this does often times disrupt the entire medical professions image but they do not seem to think much about it, because nobody seems to care for the patient or actually maybe they cannot because of missing information at this point.
Kindly, Mrs. Tosca, in MA
NEWS ARTICLE ON IOWA STUDY
Docs slow to admit mistakes
LEE BOWMAN
May 18, 2007
Scripps Howard News Service
We all make mistakes, even doctors from time to time. And in theory, it's good to admit it when we make a mistake.
But when it comes to doctors, a recent study suggests they're more likely to say it's important in theory to disclose a medical error to patients than they are to actually 'fess up.
The study, published online last week by the Journal of General Internal Medicine, was based on survey responses from 538 faculty, resident physicians and medical students at teaching hospitals in the Midwest , Mid-Atlantic and Northeast.
Researchers at the University of Iowa found that while nearly all respondents -- 97 percent -- said they would disclose a hypothetical medical error that resulted in minor medical harm, 93 percent said they would disclose an error even if it had caused disability or death.
But only 41 percent said they had actually disclosed a minor medical error they made, and just 5 percent said they had revealed a major error during their career. Moreover, 19 percent said they had made a minor medical error but not disclosed it; 4 percent said they had made a major error and not disclosed it.
What's striking is that this seems to suggest about half the doctors think they have never made even a minor medical mistake.
"It seems fair to assume that all of us have made at least a minor error, if not a major error, sometime in our careers," said Dr. Lauris Kaldjian, an associate professor of internal medicine at the university's medical college and director of its Program in Biomedical Ethics and Medical Humanities.
"Most doctors recognize that they're fallible, but they still strive for perfection," Kaldjian said. "The idea persists that the physician rides into the clinic on the white horse. To come in as the healer and then realize that you have harmed is a difficult thing to accept, let alone to admit."
The surveys did suggest that the more experience a doc had, the more willing he or she was to admit an error. And they also showed that doctors who had been sued for malpractice were not any less inclined to disclose errors.
On the other side of the bed rail, though, consider a study done at a Boston-based outpatient cancer center between February and September of 2004. Saul Weingart of the Dana-Farber Cancer Institute set up interviews between volunteer "patient safety coordinators" and the patients. Then the researchers reviewed the care and coded the events.
Their report was sponsored by the Commonwealth Fund and published in the Joint Commission Journal on Quality and Patient Safety.
One in five of the 193 patients interviewed reported having an "unsafe experience" at the clinic. But when the researchers reviewed the complaints, they found that only two incidents -- 1 percent -- were genuine adverse events, four more were considered close calls and 14 others were medical errors with no risk of harm.
Most reports turned out to be about the quality of service the patients received: long waits, miscommunication with doctors and nurses, dissatisfaction with the clinic's environment and amenities.
So just as doctors don't like to admit mistakes, the cancer patients seemed to take a larger view of the type of care they felt made them feel safe.
"The vocabulary of patient safety is confusing to patients, and we offered no explicit definition," Weingart and his colleagues wrote, adding that for patients, the idea of "unsafe care" brought up complaints about parking, security, delays and emotional distress.
They also said long-term patients who interacted regularly with medical caregivers in general may be more likely to report episodes they consider substandard care, "perhaps because they had more opportunities to be harmed."
Experienced patients were also assumed to be less worried about alienating caregivers with complaints than those seeking help for problems that are generally resolved with one or two encounters.
On the Net: http://www.cmwf.org
www.sgim.org
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