It may not seem like big news, but if you’ve followed the long-running, stubborn and mostly dug-in debate over reforming medical malpractice in the U.S., you know that when doctors and lawyers issue a joint news release, something is really going on. (As Carey put it: “Talk about the lions lying down with the lambs!”)
Formally, it’s called “Disclosure, Apology and Offer” and it’s a key provision of the new state health cost law. Massachusetts doctors and lawyers have agreed to work side by side on this less hostile (and potentially cost-saving) approach to dealing with medical errors and malpractice. It essentially boils down to disclosing mistakes, apologizing to the patient and family when appropriate and offering compensation as a way to avoid litigation when possible.
From the Mass. Medical Association, Mass Bar Association and Mass. Academy of Trial Lawyers news release:
An historic and unprecedented partnership between physicians and attorneys in Massachusetts has led to significant reforms to the medical liability system, allowing for improvements to resolving malpractice cases that both sides say could greatly benefit patients by reducing some unnecessary and protracted lawsuits while improving patient safety.
The health care cost control bill recently passed by the Massachusetts legislature and signed by Governor Deval Patrick on August 6 contains specific language that facilitates an approach of Disclosure, Apology, and Offer (DA&O) to address medical malpractice claims.
Representatives from the physicians’ and attorneys’ groups have described their agreement as “unprecedented” and applaud the Legislature and governor for their support of the reforms and including them in the cost control reform bill. Continue reading
Dr. Alice Coombs, President of the Massachusetts Medical Society, says she’s particularly excited about one element of the governor’s health care cost-cutting plan: the part that rethinks malpractice in ways that can protect physicians from major legal woes.
The plan would encourage doctors and medical providers to apologize when they’ve made a mistake and then figure out a quick resolution with the victim and family — including possible compensation — thereby avoiding a big, expensive, potentially career-killing lawsuit.
Here’s Dr. Coombs this morning, immediately after Gov. Patrick’s speech (and if you want more, see the piece today on the MMS website):
A sponge left behind after surgery triggered a judge's transformation into a patient safety advocate
There’s nothing like a personal brush with illness to radicalize a patient, or turn a passive observer into an political activist. (Think of Nancy Reagan pleading for embryonic stem cell research.)
So here’s a Florida judge, Nelson Bailey, who had a sponge left inside him after surgery, and is now a newfound convert for patient safety.
The Palm Beach Post reports:
After abdominal surgery at Good Samaritan Medical Center for diverticulitis, the pain in the judge’s belly only got worse. Repeatedly, he says, he returned to his primary doctor and complained. Repeatedly, he was sent for CT scans. And repeatedly, the metal marker on the sponge appearing in the scans was misidentified.
For five months, the surgical sponge festered near Bailey’s intestines. The pus- and bile-stained mass measured more than a foot long and a foot wide when finally removed and unwound in March.
Now that Judge Bailey has recovered (or at least partially recovered — part of his intestine rotted and had to be removed, so he can no longer engage in his favorite activity, horseback trail riding) he has a few demands. He wants equipment available in the OR that beeps when a sponge or other medical equipment is left inside a patient. And he wants to eliminate all caps on damages in medical malpractice lawsuits.
When it comes to medical errors, could the age-old practice of ‘defend and deny’ be over? Perhaps.
New research out of Brigham and Women’s Hospital shows that when doctors admit mistakes, and apologize to patients and their families, fewer lawsuits follow, Bloomberg Businessweek reports.
This idea isn’t new. In fact, I wrote about it for The Wall Street Journal back in 2004, in a front page story, Doctors’ New Tool Against Lawsuits: Saying ‘I’m Sorry.’
But actually getting doctors to admit mistakes remains painful and fraught. Here’s a first person account by a resident who nearly killed a patient, published in HealthAffairs, that shows how agonizing this process can be.