Now, here’s a malpractice case for you. Doctors operated on a patient in Japan’s Asahi General Hospital to remove a large tumor in his stomach that was causing abdominal pain. Once inside, they discovered a greenish towel that was left in his stomach since 1983.
The man, 49, has been carrying around the towel for 25 years. Of course, our military doctors has shown that, while we are no long competitive in most markets, we remain number one in such things as medical malpractice. In the infamous Feres case, surgeons removed a 30-inch towel from a patient. Click here. The Japanese towel was a mere three inches.
Notably, while the patient had to have his spleen removed, he is not suing. One has to ask whether a little more malpractice in Japan may be a better deterrent than the occasional news story.
For the full story, click here.
Hey no more Airline analogies please … I’m still recovering from the nut clustering I got from my friend Mespo.
Mespo,
There were errors as you were offending all 432 gods and goddesses by claiming you might be religious and you were being sent a message! I really agree with what you said and with the information Patty passed along.
This technique originated with the airline industry where it reduced many errors (obviously executives have excluded themselves from the practice).
Some hospitals have institued strict checklist that everyone who comes into a patient’s room must follow. These has reduced many complications from ever occuring in the first place (ie, infections rates).
These policies work for everyone as you have pointed out.
Jill
Patty C:
Sorry about the numerous typos. I meant to say “not because it will reduce claims, but because it will…” I also meant to say “sooner” rather than “soomer’. I guess today is a burn-out day.
I really think that is a good idea not because it will reduce claims and it will speed compensation since the physician will come to grips with his/her error soomer. Now they are in constant denial and the system fosters the stonewalling. I also think it will lead to a better compensation model that the protracted, expensive court battle that must be waged because of the database, thus out pricing many meritorious smaller claims. I think remorse, restitution, and forgiveness is a hard policy to dispute. Gosh, does that make me religious?
Hey mespo, from Man’s Greatest ’05…
btw, Harvard has a great Law and Psych group consisting of M.D.,J.D.’s (and PhD’s) any of whom you would likely appreciate.
http://www.insurancejournal.com/news/east/2005/07/26/57585.htm
July 26, 2005
Harvard Developing Uniform Apology Policy for Boston Hospitals
Some of Harvard Medical School’s top teaching hospitals may add a
lesson for their doctors: how to say sorry.
A national specialist on patient safety, Dr. Lucian Leape, has led a
group of physicians, patients, and hospital executives in drafting the policy for physicians to acknowledge and apologize for medical errors to their patients.
The group has circulated a 50-page draft among hospital leaders, the
Boston Sunday Globe reported.
The policy, if adopted, would create a uniform response to some of
medicine’s most difficult situations at Massachusetts General
Hospital, Brigham and Women’s Hospital, Beth Israel Deaconess Medical
Center, Dana-Farber Cancer Institute, and Children’s Hospital Boston.
The hospitals would join a growing number of U.S. medical centers and
malpractice insurers that embrace medical disclosures and apologies to patients.
“I’m trying to get all the Harvard hospitals to adopt the policy,”
said Leape, a professor at the Harvard School of Public Health. “The
time has come to be open with our patients.”
He declined to discuss details, saying the policy has not been
completed.
The Harvard hospitals, as do most hospitals, have policies for dealing with unexpected medical outcomes. The Joint Commission on
Accreditation of Healthcare Organizations, a national group that
accredits hospitals, requires hospital caregivers to tell patients
about the most serious situations, but doesn’t spell out requirements
beyond that.
In Boston, Dana-Farber has one of the most detailed disclosure
policies, and requires doctors to apologize for errors.
But elements of the Harvard hospitals’ policies vary widely, and
implementation of the policies and training is spotty, said Robert
Hanscom, director of loss prevention for the Risk Management
Foundation, which insures Harvard hospital doctors.
“We have some hospitals that have moved forward very progressively,
but we’ve seen a couple of cases recently where there’s been a real
hesitancy on the part of providers to have that conversation with
patients,” said Hanscom, who is part of Leape’s group.
Leape and other physicians working on the policy said disclosure is
“the right thing to do.” There also is growing belief among
malpractice insurers that disclosure, along with sympathy and remorse,
could head off malpractice lawsuits.
Colorado’s largest malpractice insurer, COPIC, for example, has
enrolled 1,800 physicians in a disclosure program under which they
immediately express remorse to patients when medical care goes wrong
and describe in detail what happened.
Malpractice claims against these 1,800 doctors have dropped 50 percent
since 2000, while the cost of settling these doctors’claims has fallen
23 percent.
“Yes, we’re recommending that doctors say they’re sorry,” said Dr.
Thomas Delbanco, of Beth Israel Deaconess and a member of Leape’s
group. “Be a human being. Don’t just say it; mean it.”
The hospitals’ top executives, and in some cases their trustees, would have to approve the policy.
Dr. Britain Nicholson, Mass. General’s chief medical officer, said
disclosure of medical errors is routine at the hospital; however, it
varies whether a doctor explicitly expresses remorse.
“Part of it depends on when you went through training,” he said.
“Fifteen to 20 years ago coming through medical school and residency,
we were implicitly, if not explicitly, told, ‘Don’t ever admit a
mistake,’ because it will come back to haunt you if you get sued.”
Copyright 2005 Associated Press. All rights reserved. This material
may not be published, broadcast, rewritten or redistributed.
From the article:
“Asahi hospital officials visited the man and apologised, he said.
The former patient has no plans to sue the hospital, which is in talks with him over compensation or other measures, the official said.”
******************
My guess is that much of my business would evaporate if American doctors followed this simple strategy. We have talked about it before, but many states protect this type of conversation between erring physician and victimized patient, but I see few doctors availing themselves of it unless prompted by their counsel. An apology and payment for harm caused. How novel!