Not necessarily.
That’s the finding from a recent study in the Journal of General Internal Medicine.
What the researchers did was simulate three scenarios of medical mistakes, “a year-long delay in noticing a malignant-looking lesion on a mammogram, a chemotherapy overdose 10 times the intended amount and a slow response to pages by a pediatric surgeon for a patient who eventually codes and is rushed to emergency surgery.”
Varying degrees of physician responses were then portrayed by actors, which ranged from a full apology to a partial apology to no apology at all. A questionnaire was then given to 200 adults who watched the videos.
Although viewers gave the doctors who apologized much higher ratings, and were more likely to refer other patients to them, their intent to sue remained unchanged.
There’s no question that apologizing after being responsible for a medical error is the right thing to do. But thinking that it will reduce litigation may be far-fetched, and indeed, sorry may not work in that regard.
Related posts:
- Op-ed: Injured patients deserve medical malpractice reform
- Do online physician ratings matter?
- Physician apologies, and does saying you’re sorry mean it’s your fault?
- Do electronic medical records increase physician communication of critical test results to patients?
- Medical malpractice verdicts
- The worst medical malpractice cases you can possibly imagine
- An apology for medical errors, this lawyer says don’t do it
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Kevin,
Interesting study, though doubtless needs the usual single-study grain-of-salt. My main reservation (and I say this NOT having read the study! … tho I did read the blog post) is that the reactions/intents that come from watching the videos is likely a poor substitute for the more complex process that would occur in real life.
I THINK there have been other studies of this sort, but study structure in any event would be hard to ferret out. You couldn’t just take docs who apologized v those who didn’t, for bias would run amok there, ,with the former docs likely generating stronger connections and more trust with pts even aside from apologies.
Nonetheless, an interesting study … even though I don’t quite believe it!
David Dobbs
http://neuronculture.com
I’d echo David D’s one-study caveat. The University of Michigan health system, for one, sees that medical apologies work. http://bit.ly/DI9aV For more on the subject see http://bit.ly/120rvK I invite physician groups and health systems considering training in the use of medical apologies to look at these materials and contact me with any questions.
I think it does make patients more amenable to a faster resolution, and more reasonable settlement, when avoidable error has caused damage to a patient.
I agree with earlier posts. I haven’t seen this scenario in a lawsuit, yet; where the doctor apologizes, is sued, and the case is litigated to trial. Not saying that it hasn’t happened, just that I haven’t seen it. However, for the physicians I know that apologize (next followed by their worried call to me) are usually not the ones who get sued later on. I believe this has to do more with their pre-incident developed relationships with their patients rather than the fact that they apologized. I’m not saying this is in anyway a scientific study, just observation.
So if the intent to sue remains unchanged… why not apologize?
I think it’s the right thing to do, and apologizing has served me well in my career. Because, despite the fact that I am a good DVM, I occasionally make mistakes… and MDs do, too.
I have worked in healthcare risk management and claims defense for almost 30 years now. I was advocating apologies long before any sort of shield law in my state. In my view, it is simply the right thing to do. Based on my anecdotal observation of hundreds of claims over the years, I don’t think that apology provides any sort of robust prophylaxis against litigation. It may prevent the occasional case from being filed, and it may soothe the anger on the part of the patient or family, such that a lesser amount of a settlement is accepted.
If you really talk to the Michigan people, they will indeed agree that their apology/disclosure/settlement program is not in and of itself the sole reason for their reduction in claims expenses. It is in conjunction with other tort reform and loss control efforts. They can say with a straight face that the timing of the reduction in claims expenses coincided with the onset of their disclosure/settlement program, but it is more of a correlation than causation.
I very much agree with the concepts of the SorryWorks people, and was using the same approach long before they came on the scene. I just do not buy into the belief that apologies will substantially reduce the number of malpractice claims. Probably the best way to determine if apologies start reducing claims in a significant way will be when the malpractice insurance company acturaries start reducing the premium in a meaningful way if you have an apology program. i have not yet seen any data from Tillinghast or Milliman suggesting that this is happening.
I forgot to mention in my earlier comment that many of my defense legal and risk management colleagues are admanantly against apologizing because they feel it will increase litigation. Other than anecdoctal reports, I am unaware of any data that supports this contention.
What does concern us is the difference between an apology and an admission of liability. I think apologies are peachy but discourage the admissions of liability unless I am involved in the process. Apologies rarely come back to bite you on the ankle, but admissions of liability sure can.
@MillCreek
Agree: Key distinction: apology vs. admission of liability
There are a number of measures of a successful risk and claims management program. The number of lawsuits is one, but it’s not at the top of my list. The emotional impact on the providers involved in an event, the cost of their time taken in defense, the cost of providing a defense and the amount paid to indemnify the injured are, in my experience, more important indicators. Apology can have a significant impact on all of those. However, a liability event will still be a liabiltiy event. It takes the hatefulness out of the situation, but can’t erase it.
Read an interesting letter to the editor in this morning’s paper. A woman was upset because, during an ER visit, a doctor allegedly made crude remarks about her birthmark. She complained to the hospital administrators. They sent her $20 worth of coupons for discounts at the hospital gift shop.
There’s some brilliant risk management for you.
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