March 14, 2011
A Better Approach to Medical Malpractice Claims? The
University of Michigan Experience
Journal of Health & Life Sciences Law, January
2009
By Richard C. Boothman, Amy C. Blackwell, Darrell A. Campbell, Jr.,
Elaine Commiskey, and Susan Anderson
Abstract: The root causes of medical malpractice
claims are deeper and closer to home than most in the medical
community care to admit. The University of Michigan Health System's
experience suggests that a response by the medical community more
directly aimed at what drives patients to call lawyers would more
effectively reduce claims, without compromising meritorious
defenses. More importantly, honest assessments of medical care give
rise to clinical improvements that reduce patient injuries. Using a
true case example, this article compares the traditional approach
to claims with what is being done at the University of Michigan.
The case example illustrates how an honest, principle-driven
approach to claims is better for all those involved-the patient,
the healthcare providers, the institution, future patients, and
even the lawyers. AHLA holds the copyright for this
article.
For complete article, visit:
http://www.med.umich.edu/news/newsroom/boothman%20et%20al.pdf
Video:
University of Michigan Health System Risk
Management (Length: 8:02)
Produced by the University of Michigan Health System. (Note:
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see the video, disable your browser's popup
blocker.)
Apology in Medical Practice: An Emerging Clinical
Skill
Journal of the American Medical Association, Sept. 20,
2006
By Aaron Lazare, MD
Extract: The idea that physicians should make full
disclosure of medical errors to their patients has grown in
importance since the late 1980s and early 1990s. This movement
gained momentum following the 1999 Institute of Medicine report, To
Err Is Human, an in-depth study of the extent of medical errors,
and the 2001 Safety Standards of the Joint Commission on
Accreditation of Healthcare Organizations on disclosure of patient
harm.
As physicians were encouraged to disclose medical errors, offering
an apology would inevitably seem to be the next step. What sense
would it make to admit harm without acknowledging responsibility,
offering explanations, expressing remorse, and discussing
reparations-all parts of an apology? Without such offerings, most
patients in response to such disclosures would more likely be
offended than soothed. (continued)For complete article,
visit:
http://jama.ama-assn.org/content/296/11/1401.full
(subscription or purchase required)
Liability Claims and Costs Before and After
Implementation of a Medical Error Disclosure Program
Annals of Internal Medicine, Aug. 17, 2010
Allen Kachalia, MD, JD; et. al.
Summary: The University of Michigan Health System
has fully disclosed medical errors and offered compensation to
patients since 2001. Other health systems have been hesitant to
adopt similar programs for fear that disclosure could make things
worse. This study found a decrease in new legal claims, number of
lawsuits per month, time to claim resolution, and costs after
implementation of the program compared with before implementation.
This experience demonstrates that disclosure with an offer of
compensation can be conducted without exacerbating liability claims
and costs.
For full text:
http://www.annals.org/content/153/4/213.full.pdf+html
Making Patient Safety the Centerpiece of Medical
Liability Reform
The New England Journal of Medicine, May 25,
2006
Hillary Rodham Clinton and Barack Obama
Extract: We have visited doctors and
hospitals throughout the country and heard firsthand from those who
face ever-escalating insurance costs. Indeed, in some specialties,
high premiums are forcing physicians to give up performing certain
high-risk procedures, leaving patients without access to a full
range of medical services. But we have also talked with families
who have experienced errors in their care, and it has become clear
to us that if we are to find a fair and equitable solution to this
complex problem, all parties - physicians, hospitals, insurers, and
patients - must work together. Instead of focusing on the few areas
of intense disagreement, such as the possibility of mandating caps
on the financial damages awarded to patients, we believe that the
discussion should center on a more fundamental issue: the need to
improve patient safety.
For full text:
http://www.nejm.org/doi/full/10.1056/NEJMp068100
Guilty, Afraid, and Alone - Struggling with Medical
Error
The New England Journal of Medicine, October 25,
2007
Tom Delbanco, MD and Sigall K. Bell, MD
Extract: Since 1999, health care
professionals have been focusing on To Err Is Human, the Institute
of Medicine report that sounded alarms about medical error. As we
have strived to reduce the rate of errors, systems-based practices
such as electronic order entry and procedure checklists have
proliferated. Meanwhile, little attention has been paid to the
second half of the adage - "to forgive, divine." How can we
characterize and address the human dimensions of medical error so
that patients, families, and clinicians may reach some degree of
closure and move toward forgiveness?
In interviews that our group conducted for a documentary film,
patients and families that had been affected by medical error
illuminated a number of themes.1 Three of these themes have been
all but absent from the literature. First, though it is well
recognized that clinicians feel guilty after medical mistakes,
family members often have similar or even stronger feelings of
guilt. Second, patients and their families may fear further harm,
including retribution from health care workers, if they express
their feelings or even ask about mistakes they perceive. And third,
clinicians may turn away from patients who have been harmed,
isolating them just when they are most in need.
For full text:
http://www.nejm.org/doi/full/10.1056/NEJMp078104#t=article
Malpractice Reform - Opportunities for Leadership by
Health Care Institutions and Liability Insurers
The New England Journal of Medicine, April 15, 2010
Michelle M. Mello, JD, PhD and Thomas H. Gallagher, MD
Extract: In February 2010, the Illinois Supreme
Court ruled that the state's cap on noneconomic damages in medical
malpractice cases violated the Illinois constitution.1 This
development has contributed to growing pessimism about traditional
approaches to medical liability reform. In some quarters, interest
is shifting to innovative reforms that can be implemented by health
care institutions and liability insurers without requiring changes
in the law. These approaches provide a better balance between the
interests of providers and those of patients and illuminate a path
around the political gridlock over tort reform. They also afford
opportunities for health care institutions and liability insurers
to take the lead in reforming the processes for providing
compensation for medical injuries.
For full text:
http://www.nejm.org/doi/full/10.1056/NEJMp1001603
