posted
One of the things that gets me the most about the current mania about malpractice tort reform is that the blame for costs of litigation is being placed solely on patients and their lawyers.
The role that hospitals and insurance companies themselves play in driving litigation costs up doesn't enter the picture at all. The classic response of a hospital to a claim of malpractice is denial - and their lawyers will drag the case out for as long as possible, driving costs and emotions higher, regardless of the merits of the case in question.
There's a great article below that details a quieter and not very widely supported element of reform that's afoot - one that would help push litigation costs down and increase accountability of hospitals and doctors.
CHICAGO - It's a basic lesson children learn even before their ABCs — say you're sorry when you hurt someone. But it's now being taught in the grown-up world of medicine as a surprisingly powerful way to soothe patients.
Some tort reform advocates say an apology can even help doctors avoid malpractice lawsuits, especially when combined with an upfront settlement offer.
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One catalyst, Barach said, has been emerging evidence about the scope of medical errors, including the Institute of Medicine (news - web sites)'s 1999 report that mistakes kill as many as 98,000 hospitalized Americans each year.
Dr. Rita Charon, who teaches medical students at Columbia University about forgiveness, says an apology can help both doctors and patients. Still, she said, there are some errors "that we should not absolve one another for."
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Dr. Michael Woods, a Colorado surgeon and author of "Healing Words: The Power of Apology in Medicine," said his own experience a decade ago illustrates the impact of the traditional way doctors have handled mistakes.
Woods was overseeing surgery to remove a patient's appendix. A minimally invasive surgery was planned, but a medical resident accidentally punctured an artery, which led to a more extensive operation. The patient was unhappy with how Woods handled the aftermath, including one visit during which he propped his feet up on the desk and, in her opinion, acted as if he didn't care.
Woods said he wanted to apologize but legal advisers recommended breaking off contact with the patient when she threatened to sue.
Now a consultant to doctors and the malpractice insurance industry, Woods said his research has shown that being upset with a doctor's behavior often plays a bigger role than the error itself in patients' decisions to sue.
At the University of Michigan Health Systems, encouraging doctors to apologize for mistakes is part of a broader effort to help doctors "feel comfortable in being honest with their patients," said Rick Boothman, a former trial attorney who launched the practice there in 2002.
The system's annual attorneys fees have since dropped from $3 million to $1 million, and malpractice lawsuits and notices of intent to sue have fallen from 262 filed in 2001 to about 130 per year, Boothman said.
Didn't want to post the whole article, but there's more of the same. How the current system undermines trust between doctors and patients, and how malpractice expenses were reduced at facilities that have adopted this kind of policy.
posted
It makes sense. Lawsuits are the way to settle things in a society of strangers. Imposing a lawsuit is a good way to ensure that amicable relations are no longer carried on and that both parties are dealt the maximum amount of "equality" possible.
When an attempt is made at healing the rifts and negotiating based on the special circumstances of the case, an amicable relationship can continue and the parties aren't as inclined to try to gut each other.
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posted
There are definitely lawsuits that are more about being right than about the money in the plaintiff's eyes. Treating someone well, and being willing to compensate for injuries caused, is the best protection against a lawsuit.
The problem is that apologies are admissible in tort trials, and can lead to hard questions such as, "If you didn't make a mistake, why did you apologize?" No response will make a doctor look better to the jury. Plus, it IS a bad idea to talk to the opposing party once s/he's represented by counsel.
So there are fundamental changes in the legal system necessary to make this kind of approach feasible.
posted
Well, this should probably be labeled "PRE-tort" reform.
Seriously, though. The current practices of hospitals and insurance companies play a big role in the malpractice litigation costs. Including increasing the number lawsuits.
"Tort reform" is near the top of Bush's list of legislative priorities. It's no surprise he doesn't talk about these complexities in malpractice costs.
But Kerry and his fellow Dems are also peculiarly silent on the matter.
The cynical part of me chalks that up to both parties being too financially dependent on the insurance industry to want to antagonize it.
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