Apology Programs in Medicine

Posted on February 28, 2016 by Dr. David Edward Marcinko MBA

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By staff reporters http://www.CertifiedMedicalPlanner.org

APOLOGY PROGRAMS?

[What they are – How they work]

To deal with the aftermath of medical errors, an increasing number of providers are encouraging injured patients to participate in “medical apology programs.”

The idea, proponents say, is for patients to meet with facility representatives to learn what happened and why.  It gives the patient a chance to ask questions and it gives providers a chance to apologize, and as appropriate, offer compensation.  These programs are promoted as humanitarian, and, at least in terms of providing an emotional outlet for patients, they are.

The evidence also suggests that they are about something else: money.  Every aspect of how they operate – from who risk managers involve, to what those involved are told to say – suggests a key goal is to dissuade patients from seeking compensation by creating an emotional connection with them.

A Study

The data establishes that it works, too.

A 2010 study found that at one major facility, apology programs resulted in fewer injured patients making claims and, among those that did, they accepted a fraction of the amount in settlement compared to patients who made claims before the program was instituted.

For minor injuries, no real harm is done by this; but the outcome can be cataclysmic for seriously injured patients who accept an apology in lieu of compensation.

Doug Wojcieszak, owner of the advocacy group Sorry Works, [http://sorryworkssite.bondwaresite.com] often receives requests to teach doctors how to communicate after a problem. He became interested in the topic when his older brother died at age 39 from a medical error. While losing his brother was awful, the experience was compounded by a total lack of communication and accountability afterward.

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Curiously, when an attorney suspects that he has committed legal malpractice, he must disclose it to the client and recommend that the client seek outside counsel to get objective legal advice on how to proceed. By contrast, when a doctor suspects that he has committed medical malpractice, at many facilities he is expected to employ a set of protocols that discourage the injured patient from considering the need for compensation. Yet, while an attorney could be disbarred for this sort of behavior, medical apology programs widely receive praise.

Source: Gabriel H. Teninbaum JD: Suffolk University Law School-Chapman Law Review Research Paper 11-30.

Conclusion

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Foreword by: J. WESLEY BOYD MD PhD MA

 Harvard Medical School

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3 Responses

  1. Hope Hetico RN MHA, on December 16, 2016 at 1:42 PM said:

    PCPs are Skittish When it Comes to Discussing Medical Errors: Study

    According to a new survey conducted by researchers at Georgia State University, whereas 77% primary care physicians would inform their patients about a medical error in some capacity, only a minority would provide a full disclosure that included specific details.

    The Georgia State University researchers asked 300 primary care physicians about how they would disclose a medical error involving two hypothetical cancer diagnoses.

    Most of the respondent physicians said they would offer limited or no explanation and limited or no apology, which falls short of both national guidelines and patient expectations.

    Source: Univadis [12/12/16]

    Liked by 1 person

  2. Ann Miller RN MHA, on February 5, 2017 at 6:26 PM said:

    Apology Laws Don’t Help Doctors Avoid Malpractice Payouts

    Laws that allow doctors to apologize to patients with the provision that the apology not be used in lawsuits fail to limit medical malpractice liability risk, according to a new study from Vanderbilt University. “State apology laws are reforms to state rules of evidence and exclude from trials statements of apologies, condolence, or sympathy made by healthcare workers (sometimes only physicians) to patients,” it says in the paper, “Sorry Is Never Enough: The Effect of State Apology Laws on Medical Malpractice Liability Risk.”

    Apology laws are “intuitively appealing but empirically unfounded,” says Benjamin J. McMichael, a postdoctoral scholar at Vanderbilt’s Owen Graduate School of Management and one of three authors of the paper. “In general, the results are not consistent with the intended effect of apology laws, as these laws do not generally reduce either the total number of claims or the number of claims that result in a lawsuit,” according to the study. “Apology laws have no statistically significant effect on the probability that surgeons experience either a non–suit claim or a lawsuit.”

    Source: Vanderbilt University Medical Center Research News [2/2/17]

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