The New York Times had an interesting article this Sunday called Doctors Say 'I'm Sorry Before See You in Court, about a movement in some hospitals toward openly admitting mistakes to patients, both as a way to diffuse the tension that often leads to litigation and as way create a more open learning environment. The early results also suggest that it is one of those instances where the misguided paranoia of the legal profession -- where lawyers have counseled doctors for years to not admit mistakes -- may have done more harm than good. And lawyers are starting to change their tune on this as well. The Times reports:
At the University of Michigan Health System, one of the first to experiment with full disclosure, existing claims and lawsuits dropped to 83 in August 2007 from 262 in August 2001, said Richard C. Boothman, the medical center’s chief risk officer.
“Improving patient safety and patient communication is more likely to cure the malpractice crisis than defensiveness and denial,” Mr. Boothman said.
Mr. Boothman emphasized that he could not know whether the decline was due to disclosure or safer medicine, or both. But the hospital’s legal defense costs and the money it must set aside to pay claims have each been cut by two-thirds, he said. The time taken to dispose of cases has been halved.
The number of malpractice filings against the University of Illinois has dropped by half since it started its program just over two years ago, said Dr. Timothy B. McDonald, the hospital’s chief safety and risk officer. In the 37 cases where the hospital acknowledged a preventable error and apologized, only one patient has filed suit. Only six settlements have exceeded the hospital’s medical and related expenses.
The question of when admitting mistakes is a wise idea and how to do it is also an area that leadership researchers have studied in recent years. My next post will focus on that research, but as frequent readers of this blog know, I've always been fascinated by these issues, and have argued that the best single diagnostic question for determining if an organization is learning and innovating as it moves forward is: What Happens When People Make a Mistake?
P.S. The best book I know of on medical mistakes is Charles Bosk's Forgive and Remember. It is fairly academic, but so well-written and compelling that it is hardly dull.
P.P.S. I was reading through old posts on Metacool and came across one that is the same spirit as my diagnostic question (I should say "our" question, as it was developed with Jeff Pfeffer). Check out Diego's post Where's your place for failing?