Comments on: Do physician apologies make it less likely for patients to sue for medical malpractice?

By: W

Sun, 20 Sep 2009 21:04:32 +0000

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.

By: Kathy Wire

Kathy Wire — Sun, 20 Sep 2009 19:05:00 +0000

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.

By: David Harlow

David Harlow — Fri, 18 Sep 2009 20:46:09 +0000

@MillCreek

Agree: Key distinction: apology vs. admission of liability

By: MillCreek

MillCreek — Fri, 18 Sep 2009 15:28:54 +0000

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.

By: MillCreek

MillCreek — Fri, 18 Sep 2009 15:21:08 +0000

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.

By: Do doctor apologies curb malpractice suits?

Do doctor apologies curb malpractice suits? — Thu, 17 Sep 2009 10:53:45 +0000

[...] new study, based on video simulation, may raise doubts. [ACP Internist, Kevin MD, Ronald [...]

By: Outrider

Outrider — Wed, 16 Sep 2009 21:41:40 +0000

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.

By: DocbLawg

DocbLawg — Wed, 16 Sep 2009 15:44:26 +0000

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.

By: SarahW

SarahW — Wed, 16 Sep 2009 14:30:08 +0000

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.

By: David Harlow

David Harlow — Wed, 16 Sep 2009 13:20:28 +0000

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.