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THIS WEEK'S EDITION:
- Scheduling speeches on disclosure and apology for the Fall
- Star Insurance presentation
- Sun-Rise Hospital presentations
- Newsweek Article on Denial
SCHEDULING SPEECHES ON DISCLOSURE AND APOLOGY FOR THE FALL
Sorry Works! is beginning to schedule presentations on apology and disclosure for this Fall. All presentations can be approved for CME/CEU credits. So, if you need a speaker on disclosure and apology for Grand Rounds, ethics training, or to discuss Sorry Works! with the senior leadership of your hospital or insurer, please let us know by e-mailing doug@sorryworks.net or calling 618- 559-8168. We look forward to hearing from you.
STAR INSURANCE PRESENTATION
Last week was hectic for Sorry Works! spokesperson Doug Wojcieszak, first traveling to Michigan to speak to physicians covered by Star Insurance and then later in the week traveling to Las Vegas to speak to Sunrise Hospital, which is owned by HCA (see below).
We had a large crowd of physicians in the Detroit suburb of Troy , Michigan for a dinner presentation. They had a lot of questions about Sorry Works/disclosure and apology and also about their insurance carrier's interest in Sorry Works! It was a very good evening and we want to provide a tip of the hat to Eddie Sims, Lee Elston, and the entire Star Insurance team for providing a great venue for Sorry Works! Star Insurance is a growing med-mal carrier; to learn more about them visit their website: http://www.starphysician.com
We are excited every time we are provided the opportunity to speak before an insurance company. Med-mal insurers are quickly becoming interested in disclosure and apology, and we stand ready to help them with presentations, training & consulting, information, and other resources. We are already working with several med-mal carriers, but we want to work with more insurers. If you work for a med-mal insurer and want to learn more about Sorry Works!, e-mail us at doug@sorryworks.net or call 618-559- 8168
SUNRISE HOSPITAL PRESENTATIONS
On Friday and Saturday Wojcieszak provided two presentations to physicians at Sunrise Hospital in Las Vegas , which is owned by HCA Hospital System. Again, we had great crowds both days and a tip of the hat to Amber Carter and the entire Sunrise team for making these presentations a reality.
We received many good questions and comments from the physicians at Sunrise Hospital . The best comment was from a younger physician who made the point that for apology and disclosure to be credible physicians and providers must have good bedside manner throughout the relationship with patients and families. The Sunrise physician correctly pointed out that disclosure/apology will appear phony to patients/families if a doctor, who all along has been cold, aloof, and a poor communicator, all the sudden is Mr. Nice Guy, apologetic, and caring after an adverse event. Very, very true.
Good customer service is the underlying message in everything we teach and preach at Sorry Works!, and this physician's comment resonates well with Sorry Works! You need to have a good relationship and good customer service principles throughout the interface with patients/families, and customer service reallly needs to shine when the chips are down.
On the flip side, attorneys we work with tell us that poor customer service on the front end can mean adverse events are more likely to produce litigation. Yes, a broken TV in a patient's room that goes unfixed, a cold meal, a nurse continually not answering the call button, and/or a physician who is rude can actually lead to a medical malpractice lawsuit! You have to think of it from a patient/family perspective: "The TV doesn't work, the food stinks, the nurse never helps me, the doc is a real jerk, and now this bad outcome! I've had it with this band aid station of a hospital. Where's my lawyer?!!"
We are already looking forward to a return trip to Las Vegas this October to speak again to physicians at Sunrise and other hospitals in the area.
NEWSWEEK ARTICLE ON DENIAL
Below is an interesting column that appeared in Newsweek a few weeks ago. The article is on denial and one passage from the piece sums up its relevance to the med-mal issue: "If someone's self-image as competent and smart is challenged by the truth that he made a mistake, he is more likely to deny that truth." Great article to share with colleagues and post in the physicians' lounge.
The Truths We Want to Deny
By Sharon Begley
Newsweek
May 21, 2007 issue - A man who resented his parents' favoritism toward his younger brother was receiving psychotherapy in Boston for relationship problems. His therapist thought they were making progress, but she knew a problem loomed. Pregnant, she worried that her fragile patient might view her maternity leave as abandonment or rejection. She held off revealing her situation until she was six months along, last year. "Have you noticed anything about me?" she asked. The patient said he had not, so she told him she was pregnant. Looking at her bulging abdomen, he said she couldn't be; he was a keen observer of women's bodies and had made a habit of scrutinizing her because he worried this would happen. No, he said; you're not pregnant.
Denying the evidence of your eyes is the most extreme form of the coping mechanism called denial. But denial comes in milder forms as well. Parents refuse to believe their child is on drugs; that baggie under his bed contained oregano. A husband maintains his wife cannot be cheating; those late nights she spends with a friend are purely platonic. A wife denies that her husband is gay; he's just been too tired for sex with her these last few years.
And a president who insists that a war will succeed despite setback after setback? It's risky to put a politician on the couch, but that has not kept President Bush's critics from charging that he is "in a state of denial" about the situation in Iraq, as Sen. Harry Reid said last month. The phrase was the title of Bob Woodward's latest book on the war, and in January, USA Today editorialized that Bush is "in denial about the insurgency that has plunged ( Iraq ) into civil war."
This could all be dismissed as psychobabble, except for one thing. Psychology researchers, including some who advise politicians, have reached the same conclusion. "I do think there is denial on Bush's part in his running of the war," says Kerry Sulkowicz, clinical professor of psychiatry at New York University Medical Center . "He seems unmoved by the extent of the evidence that things are far worse than he believes. The tip-off for denial is perpetual optimism, a pathological certainty that things are going well."
Bush could, of course, know full well that the United States cannot achieve its goals in Iraq . If so, then he is lying not to himself but to us (for reasons scientists would have a field day with, but that's another story). But while it's always risky to psychoanalyze a politician from afar, a few things in his past are consistent with the capacity for denial. When he was 7, his baby sister died of leukemia. Bush, while certainly not denying her death, tried to cheer up his grieving mother, saying everything would be OK. Also, those who abuse alcohol, as Bush has admitted doing, typically need to see the world in black and white in order to stay on the wagon. "It's how they control their addiction," says Sulkowicz. "It reflects an inability or refusal to see shades of gray."
People resort to denial when recognizing that the truth would destroy something they hold dear. In the case of a cheating partner, denial lets you avoid "acknowledging evidence of your own humiliation," says New York psychoanalyst Leon Hoffman. Short of catching a spouse in flagrante delicto, evidence of infidelity is usually ambiguous. "It's motivated skepticism," says psychologist Peter Ditto of the University of California , Irvine . "You're more skeptical of things you don't want to believe and demand a higher level of proof." Denial is unconscious, or it wouldn't work: if you know you're closing your eyes to the truth, some part of you knows what the truth is and denial can't perform its protective function.
One thing we all struggle to protect is a positive self-image. "The more important the aspect of your self-image that's challenged by the truth, the more likely you are to go into denial," says Ditto. If you have a strong sense of self-worth and competence, your self- image can take hits but remain largely intact; if you're beset by self-doubt, however, any acknowledgment of failure can be devastating and any admission of error painful to the point of being unthinkable. In their new book, "Mistakes Were Made," psychologists Carol Tavris and Elliot Aronson argue that self-justification and denial arise from the dissonance between believing you're competent, and making a mistake, which clashes with that image. Solution: deny the mistake. Similarly, if a political leader believes himself competent and wise, and a decision has disastrous consequences, the only way to reconcile self-image with failure is to deny the failure. As Tavris and Aronson write, a president who believes "he has the truth becomes impervious to self-correction." He blinds himself to information that might make him doubt his decision. There are exceptions, however. When the Bay of Pigs proved to be a fiasco, JFK said responsibility was "mine and mine alone." No denial there.
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