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September 20th, 2007 NEWSLETTER
Doug Wojcieszak, Founder & Spokesperson
Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net
SPECIAL NOTE: We experienced technical difficulties over the last three days, which is the reason our newsletter has been delayed this week! We apologize to our loyal readers for the delay.
THIS WEEK'S EDITION:
- Empathy versus Apology - Important Clarifications
- Advertising Age Article on Apology and Customer Service
EMPATHY VERSUS APOLOGY - IMPORTANT CLARIFICATIONS
Sorry Works! and the disclosure movement have a lot of momentum and we have enjoyed several positive developments lately; however, many healthcare providers are still confused about what exactly apology means and when is the appropriate time and context to say "sorry." Indeed, many well-intentioned providers don't want sympathy and empathy to be confused with admissions of guilt. Likewise, there are some providers who believe apology with acceptance of responsibility is not possible or even necessary after an investigation shows injury or death was caused by an error.
To be clear, Sorry Works! talks of disclosure and apology in three steps:
Step 1) In the immediate aftermath of the adverse event approach the patient/family with empathy. "We're sorry this happened." Discuss only what you know and do NOT assign blame or accept fault, yet. Promise a thorough and quick investigation that will be shared completely with the patient/family;
Step 2) Quickly conduct your investigation to find out if the standard of care was breached, or not.
Step 3) Share the results of your investigation with the patient/family. If there was an error, then this is the time for the real apology - which includes accepting responsibility - as well as discussing how changes will be made to prevent the mistake in the future and a discussion of compensation for the injured patient/family. If, however, the investigation showed there was no error empathy is order again - "We are sorry this happened, and let's discuss this complication with you and answer any questions you have" - but no admission of fault is required, no settlement should be offered, and any litigation will be contested and never settled.
Directly below is a column recently written on this subject by med- mal defense attorney Jim Saxton of the law firm of Stevens & Lee (www.stevenslee.com). Jim is the co-chair of the Stevens & Lee health litigation department. Sorry Works! has partnered with Stevens & Lee to provide disclosure training. To find out more about our disclosure training program, click on this link:
http://www.sorryworks.net/train.phtml. Jim Saxton's columns are distributed every Friday free of charge via e-mail. To sign up for Jim's columns click on this link:
http://www.hcmarketplace.com/prod-1412-ELRC.html
Clarifying the "I'm sorry" phenomenon
Dear Jim:
The entire "I'm sorry" phenomena continues to get a lot of press, and several members of our medical staff have asked about it. However, there seems to be a good deal of confusion. Don't get me wrong, we are in favor of the initiative, but it seems as if there are some kinks to work out.
Tammy Bliss
Risk Manager
Orlando, FL
Dear Tammy:
There is a good deal of unnecessary confusion surrounding this concept. Let me try to clarify a couple of points. The concept of "sorry" works. In other words, almost every time, showing empathy and using enhanced communication techniques with patients post- adverse outcome will help make an unfortunate situation better, and often reduces the potential that the patient will see a lawyer.
There is a subset of adverse events that necessitate an apology or an acceptance of responsibility. Medicine is complex, and many adverse events are known complications of procedures. It is time we realized that this is not malpractice, but due diligence should clearly be done. There are other cases in which an obvious error has occurred: a medication error, wrong site surgery, etc. These are situations in which an apology, acceptance of responsibility, and compensation truly work out for all involved. Obviously it is the most compassionate outcome for the patient and family. Perhaps the confusion lies in the belief that the two types of events are the same. There is an important difference between showing empathy and accepting responsibility.
We also need to have a process in place to handle communication after adverse events. Establish some basic training on how to show empathy without accepting responsibility (there are certain phrases, ways to express body language, etc). By having an event management process in place you have a resource for providing and coordinating information and support when these unfortunate events occur.
Often in cases such as these, we focus on the benefit to the family. That is pretty clear. Other times, we focus on the economic benefit for an insurance company. That too has been fairly well established. However, I would argue that one of the biggest benefits is for the doctor. When there is an adverse outcome, the doctor suffers tremendously. The ability to get closure on his or her part by simply reconnecting with the patient and family, showing empathy, or giving an explanation has true therapeutic value. It also allows the doctor to deal with the issue immediately, especially in cases where a mistake was made, and prevents the matter from dragging out for several years in contentious public litigation. I understand that sometimes a case cannot be easily settled even if you want to. However, when this process is handled by experienced individuals, those are actually few and far between. Hope that helps.
Sincerely,
James W. Saxton, Esq.
Stevens & Lee
Lancaster, PA
P.S.
Have questions?
Send them to: jws@stevenslee.com
ADVERTISING AGE ARTICLE ON APOLOGY AND CUSTOMER SERVICE
Below is a nice article on apology and customer service from Advertising Age. which gives a nice plug to our friends at the University of Michigan for their succcessful disclosure program. Moreover, this article shows that the lessons of Sorry Works! are universally applicable to folks from all professions and walks of life. So, please pass it along to your friends, both medical and non-medical.
Steve Jobs, My Fruit Vendor and How to Keep Customers
A Lesson in How Transformative an Apology (and Customer Service) Can Be
By Lenore Skenazy
Published: September 17, 2007
It's almost as if Steve Jobs was channeling my fruit vendor. First, they both totally annoyed their customer bases -- in Jobs' case, his Apple acolytes, in my fruit vendor's case, me.
Steve Jobs treated his iPhone early adopters as valued customers when he apologized for a $200 price reduction.
Jobs did this by basically saying "Sucker!" to his overpaying early adopters, while my fruit vendor busily tried to persuade me to buy two pounds of tomatoes when I'd only asked for one, and went so far as to put a couple of mushy ones into the pile, as if I wouldn't notice them oozing. Puh-lease.
Then, the next day, Jobs realized: "I was a jerk!" Or at least: "People think I was a jerk!" which, in marketing, is worse. So he made amends. And if the one iPhone buyer I spoke to is any indication, all was forgiven. As the buyer, Baltimore psychotherapist Daniel Buccino, said, "At first I felt gypped. I had bought my phone literally a week before the announcement. But the next day, when he said, you know, he really botched it" -- that was enough to get back in the therapist's good graces.
As for my fruit man, he did not deny culpability (pulpability?) when I removed the bad tomatoes he was trying to foist upon me. He simply bagged up the others and, just as I was about to walk off, he presented me -- and my son -- with a free banana.
Apples. Bananas. Same story: We who'd been peeved initially were suddenly charmed by a vendor willing to apologize and treat us like valued customers. And considering that this was right after we'd been treated as totally unvalued customers just goes to show you how transformative an apology can be, and how really good customer service can change a whole relationship.
So why isn't every company doing this -- making the customer feel important or cherished or even better, right?
Part of the reason, says Dov Seidman, author of "How" and CEO of LRN, is that companies think that if they simply provide a good or service, they've done their job. But today, goods and services are commodities. It's how you provide them that sets you apart.
Seidman cites a hospital that was worried about all of its malpractice suits. It decided to try something radical: Instead of clamming up, it had its doctors start apologizing when they did something wrong.
Rather than giving ammo to its antagonists, this led to a whopping 50% reduction in lawsuits. How come? Seidman says most of the patients were just dying to hear those three magic words: "I was wrong." (Those words work magic in a marriage, too.)
And speaking of marriage, relationships -- even commercial ones -- work best when the partners feel like equals.
"I don't think 15 minutes is a long wait," said Russel Thompson, a top hair colorist in San Francisco. But if it's any longer, he'll offer a free manicure or bottle of shampoo. With this always comes an apology. Is it any wonder his customers keep coming back?
Some restaurants and doctors' offices have started taking waiting time into account too, says Elaine Berke, founder of EBI Consulting. Rather than making their patrons just sit there stewing, they'll take a cellphone number and call when everything's set. And, again, they'll apologize. If only airlines would do the same!
The fact that we have come to accept the stewardess barking, "WE CANNOT TAKE OFF UNTIL EVERYONE IS SEATED!" -- as if it's our fault we're four hours behind schedule -- just illustrates how accustomed we've become to callousness, says St. Louis University associate marketing professor Mark Arnold.
The company that trains its employees to be a little more sympathetic, apologetic and ready to treat us like people they might actually see again...will!
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