Feb 8, 2010

Medical Apologies in healthcare reforms.

Recently, i read an article on Medical apologies, and its position in the healthcare reform. The idea does sound like a possibly effective self-regulation method. It can definitely bring down litigation costs and encourage openness and efforts to improve quality by healthcare institutions.

Medical Apologies: Do right and do well

An often overlooked tool in health care providers' struggle with the malpractice crisis is the medical apology.  Two thirds of the states provide some form of protection for the medical apology (i.e., a simple apology is not admissible in court as an admission of culpability), and settlements reached post-apology are almost invariably lower that they would be otherwise.  (In the current environment, articles on medical apologies are popping up everywhere ... even in the NY Times business section.)

It is important to note that an effective apology policy does not stop with the simple apology -- I'm sorry that this happened to you -- but must include a commitment to conduct a root cause analysis, to communicate the results to the patient and/or patient's family, to implement systems improvements based on the results of the root cause analysis, and to offer a specific apology once the analysis is complete, and an offer of monetary compensation if the provider or its systems were at fault. 

Often, following a bad outcome, a patient's family member may wonder if he or she could have done something different to prevent the bad outcome, and the analysis can serve to put his or her mind at ease.  In addition, patients and family members often sue because they want to be sure that 'nothing like this ever happens to anyone else.'  If a provider can demonstrate that a root cause analysis has been done and systems improvements made so that the same mistakes cannot be repeated, then that impetus for filing suit is removed.

For example, the University of Michigan health system reduced malpractice payouts by about 50% following implementation of its program.  Other examples of successful programs abound.  (And here's another resource on medical apologies.)

Originally by-
David Harlow

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