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Sunday, June 1st 2008

Physicians Saying I'm Sorry

Their is a (perhaps) growing trend of physicians being very candid when they make mistakes when caring for patients and saying I’m sorry.

For decades, malpractice lawyers and insurers have counseled doctors and hospitals to “deny and defend.” Many still warn clients that any admission of fault, or even expression of regret, is likely to invite litigation and imperil careers.

But with providers choking on malpractice costs and consumers demanding action against medical errors, a handful of prominent academic medical centers, like Johns Hopkins and Stanford, are trying a disarming approach.

By promptly disclosing medical errors and offering earnest apologies and fair compensation, they hope to restore integrity to dealings with patients, make it easier to learn from mistakes and dilute anger that often fuels lawsuits.


Despite some projections that disclosure would prompt a flood of lawsuits, hospitals are reporting decreases in their caseloads and savings in legal costs.

This ‘trend’ has been discussed in detail elsewhere. I’ll say though that for all the time I give to the current medical malpractice environment from the physician perspective, the environment is just as bleak from the patient side. The work of the godfather of medical malpractice research has consistently implied that the vast majority of patients who actually suffer harm due to negligence never even seek compensation. I’d like to know what these physician disclosure practices do to that rate.

Granted, we wouldn’t want physicians themselves to be the sole arbitrator of negligence, disclosure and compensation. However, under the current flawed medical tort system this (perhaps) growing system of apologizing and offering some form of compensation is a nice addendum. The ideal system, here very non-specifically described, is a no-fault system headed by expert healthcare courts/arbitrators which should hope to have a much better track record than the current system. Both in terms of actually compensating patients suffering negligence and holding physicians accountable when they actually commit gross negligence.

I suppose I can dream.