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June 17, 2008 NEWSLETTER
Doug Wojcieszak, Founder & Spokesperson
Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net
THIS WEEK'S EDITION:
- Sorry Works! Editorial: Changing the Discussion on Med-Mal
- Sorry Works! Presentations
- Doctor-lawyer project tackles malpractice
SORRY WORKS! EDITORIAL: CHANGING THE DISCUSSION ON MED- MAL
One of the important pieces of a real apology following a medical error is the discussion and negotiation of upfront compensation, including financial issues as well as non-monetary issues. Many providers and insurance professionals get nervous when money is brought into the equation. Some become angry and rebut, "Med-mal is always about the money! Why ever would we want to inject money into the conversation - greedy patients, families, and their lawyers will just want more of it!"
This situation/scenario has been an important topic in current Sorry Works! presentations by Sorry Works! Founder Doug Wojcieszak (see immediately below). The retort to this challenge is who decided to make med-mal all about the money? Answer: medical and insurance interests! By removing or taking away apology, admission of fault, and discussion of how medicine will improve post-error, the patient/family is only left to fight over money. And if all we're going to talk about is money, let's make the number as big as possible, doctor, so you can feel some of the pain you inflicted on my family, says the angry litigant. However, when you inject apology, admission of fault, and explanations of improvement to health care, then money because less of an issue. True, money is still important, but because you've removed anger from the patient/family, you will change the discussion from "I want to own this hospital/medical practice" to "What's fair for me so my family can move on?"
The first data set on disclosure - the Lexington VA - taught us this lesson. When compared to 35 similarly situated VA hospitals, the Lexington facility was on the high end for claims because they were disclosing so much but in the bottom quartile for money going out the door. Now, if you buy into traditional tort reform thinking this data set cannot make sense. High claims should equal high money going out the door, right? Not necessarily if you can remove anger and change the discussion. Honesty and candor remove anger and do change the discussion from punishing the institution to learning, healing, and fair and reasonable closure for all sides.
Doctors, nurses, and insurance professionals have been trying to change the discussion on med-mal with tort reform and public relations efforts aimed at shaming trial lawyers and scaring patients/families with limited success. Sorry Works! changes the discussion but in a much more effective and immediate fashion. Customer service is the key - be proactive and draw your customers closer with enhanced communication & problem solving techniques and the discussion will change - for the better!
SORRY WORKS! PRESENTATIONS
Sorry Works! has been on the road a lot lately, and is finishing out Spring with a bang. Last week Sorry Works! Founder Doug Wojcieszak was at Loyola University Medical Center in Chicago, and the week before that in Florida to receive the endorsement of Sorry Works! by the Florida Patient Safety Corporation. This week it's off to New Hampshire to speak to the Northern New England ASHRM chapter and back to Chicago to speak at a patient safety conference at Northwestern Hospital. Next week, out to Los Angeles to speak at a major hospital.
Sorry Works! is already booking presentations for the fall - the calendar is filling up quickly. To inquire about a Sorry Works! presentation, call 618-559-8168 or e-mail doug@sorryworks.net.
Lastly, the Northern New England ASHRM chapter which is hosting Sorry Works! this week, purchased a copy of the Sorry Works! Book for each attendee of their conference. We provide bulk discounts of the Sorry Works! book....for pricing information contact doug@sorryworks.net or call 618-559-8168. Individual copies of the Sorry Works! Book can be ordered by visiting this link: http://www.sorryworks.net/booksoon.phtml .
DOCTOR-LAWYER PROJECT TACKLES MALPRACTICE
Below is an article that appeared earlier this Spring discussing how doctors and lawyers in the Key Stone State are trying to work together on malpractice issues - instead of fighting. Good article, especially the bolded section about people sue to find out what happened! Other important themes common to Sorry Works! are bolded as well in the article.
Philadelphia Inquirer
March 4, 2008
Doctor-lawyer project tackles malpractice
By Stacey Burling,
Inquirer Staff Writer
Doctors and lawyers in Montgomery County are doing something unusual: working together.
Members of the county's bar association and medical society, along with Abington Memorial Hospital, today are launching a pilot project they hope will keep more malpractice disputes out of court.
Lawyers and doctors will work in teams to mediate conflicts between patients and the hospital or doctors. The hope is that the new approach will resolve problems more quickly and humanely, without the demonization of both sides that can occur in malpractice battles.
Whether it will save money remains to be seen. Project leaders say that is not the primary goal.
John J. Kelly, Abington Memorial's chief of staff, said he wanted to avoid the "harshness" of litigation. "At the end of the day, I think everybody walks away feeling like it's a much more productive process, and it's a healing process," he said of mediation.
"I think litigation makes everything so much more painful for everyone, and I'm not sure healing ever occurs."
Planning for the project started three years ago after a nudge from the state Supreme Court. It encouraged counties to look at alternatives to traditional court battles as doctors threatened to leave Pennsylvania because of skyrocketing malpractice-insurance rates. Not much has happened elsewhere in the state, but doctors and lawyers here pursued it because "there's got to be a better way to do things than the way we've been doing them," said Mark Lopatin, a rheumatologist, who led the medical society's part of the effort.
People on both sides say the current system is emotionally draining, even when you win.
"Clients hate courtrooms," said Robert Morris, president of the Montgomery County Bar Association. "I haven't ever had a client that wanted to get in the witness stand."
The project deals with unhappy patients and their families through a two-step process. In the first, doctors and nurses at Abington have been trained to listen to such patients and explain what happened in as much detail as possible. Project leaders say many people who sue do so primarily to find out what happened.
If that is not enough, patients can move to mediation, a process that helps them hammer out a settlement with their doctors. The mediator shuttles between the sides, bringing their positions together. Unlike a judge or arbitrator, the mediator does not decide the case. Instead, the patient and doctor - or more likely their attorneys - determine an acceptable outcome. Usually that involves money, but patients also often want an apology and assurance that steps will be taken to prevent future mistakes.
If the sides are still fighting, patients still have the option of going to court.
In this region, Drexel University College of Medicine's doctors have the longest-running mediation program. Theirs often uses a team approach, pairing lawyers who typically represent patients with those who defend doctors. Abington's new program creates even more unusual teams. A lawyer with health experience will be the lead mediator, and a doctor will be his "medical partner."
"It's precedent-setting, this project," said Jane Ruddell, a former health-system lawyer who now runs a company devoted to alternative dispute resolution. "It's really trying to change a culture."
Ruddell ran a training session last week in the bar association's Norristown office to train about 30 doctors and lawyers to be mediators. Many of the lawyers had previous experience with mediation, but the daylong program was an eye-opener for the doctors, who understood for the first time how hard and time- consuming it was to sort through strong emotion and find common ground.
In a training exercise, the doctors and lawyers were split into groups for some role-playing. Abington Memorial obstetrician- gynecologist Robert Michaelson played the mediator for one. The bar association's Morris was an angry woman with cancer, and Mark Pyfer, president of the Montgromery County Medical Society, was her even angrier husband.
The patient in the case had had foot pain, which the doctor thought was caused by a pinched nerve. The patient decided not to have surgery the doctor recommended and later lost part of her leg after the cancer was discovered.
"Michaelson got into trouble almost immediately, waiting too long to separate the warring parties. He ran out of time without getting close to a settlement, but Morris, who is a trained mediator, and Pyfer, a novice, proved a good team.
"I thought she was negligent because she never paid much attention to me," Morris said petulantly.
"Dr. Reynolds can say she's sorry, but I don't think she has any idea what it's like to go through life with one leg," Pyfer chimed in. Then he asked for $10 million.
Doctors came away from the experience understanding why the lawyers will take the lead in mediations, at least in the beginning.
"The most striking thing about this was....how difficult this is," said Lopatin, the rheumatologist.
Frank Murphy, a lawyer who attended the training, said it might be harder than the hospital anticipated to avoid malpractice filings and to persuade lawyers to be totally open with one another. Legal- filing deadlines, strategy, and payment agreements give lawyers an incentive to file in court and, sometimes, to stretch out the proceedings.
Advocates of mediation say it is often cheaper than court because there are fewer exhibits and medical experts to pay for.
Participants usually sign confidentiality agreements, a step that supporters say spares everyone embarrassment. The downside of the secrecy is that mediated cases create no legal precedent and leave no public record. Monetary settlements are reported to the National Practitioner Data Bank. But its information is available only to hospitals and professional groups, not consumers.
Some doctors also worry that mediation will be just one more step on the way to court. That has not been Drexel's experience. Of 40 cases that have gone to mediation, only three were unresolved.
Those involved in the Montgomery County experiment say it is more likely to give patients what they really want: early action, an apology, and information. "Patients want answers. That's what they want more than anything," said Sheila Stieritz, a former director of patient safety at Abington Memorial, who consulted on the pilot project. "And if it's something really serious, most patients want it not to happen to anybody else."
Contact staff writer Stacey Burling at 215-854-4944 or sburling@phillynews.com.
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