'I'm sorry' may be a malpractice Rx
But Tucson docs disagree about state's new law
By Carla McClain
ARIZONA DAILY STAR
Now that Arizona doctors can apologize to patients for making mistakes - without legal risk - the unhappy era of doctor-patient hostility may finally start to ease, say experts on this issue.
And with the new era will come a drop in the number of malpractice lawsuits filed against physicians, studies of hospitals and other states with a "say-you're-sorry" law similar to that just passed in Arizona show.
"This is an effort to return to an earlier, less-hostile way of doing things in medicine, and I'm very hopeful it will reduce lawsuits," said Dr. Thomas Purdon, a recently retired Tucson obstetrician-gynecologist and a leader in the fight for tort reform in Arizona.
"Any doctor wants to be able to express sympathy and be empathetic with patients. But in the current medical-legal climate, any 'I'm sorry' can be used to blame the doctor, and that has driven a wedge between doctors and patients," said Purdon. He added that doctors today are told to shut up and fight "if anything at all goes wrong."
"Maybe I'm overly optimistic, but I really think we're going to see that change now."
However, many doctors remain skeptical that the new law will change anything for the better - including the behavior of doctors themselves.
And several patients involved in malpractice lawsuits say an apology did not and would not change their decision to sue.
"The doctor did call and apologize - in a general sort of way, and after we asked him to," said Christina Hernandez, whose father died of colon cancer after his doctor failed to do a full bowel examination that would have found the cancer.
"But in the end, when the medical bills started piling up and we knew we were going to lose our father because of this, we had to go ahead with the lawsuit. It was the doctor's fault this happened."
Nevertheless, medical authorities fought for and the Arizona Legislature did pass last month a new "say-you're-sorry" law - allowing a doctor to apologize without having that statement used in court - at least in part because it is getting results in hospitals and states that have tried it:
? A similar policy used for more than a decade at the VA hospital in Lexington, Ky., has cut that hospital's average lawsuit settlement cost to $16,000 - compared with the national average of $98,000.
? The legal budget of the University of Michigan Health System was cut from $3 million to $1 million a year during the 18 months after a doctor-apology policy was enacted.
? After Colorado passed such a law two years ago, only one lawsuit has resulted from 148 apology encounters between doctors and patients, according to the Denver-based COPIC Insurance Co., a medical liability insurance carrier.
In recent years, about a dozen states have passed such laws, including North Carolina, Oregon and Texas, as one way to get some control over the medical malpractice crisis now spreading nationwide that has forced many physicians to move or get out of practice entirely.
In Tucson, a severe shortage of neurosurgeons, as well as trauma, hand, burn and pediatric surgeons, is blamed on skyrocketing malpractice premiums these doctors must pay. Last year, premiums jumped 16 percent to 92 percent in Arizona, depending on the medical specialty.
In real dollars, an Arizona surgeon is now paying about $80,000 a year for malpractice insurance, compared with less than $30,000 two years ago.
After paying out $40 million more for malpractice cases since 2000 than in previous years, officials at the Mutual Insurance Co. of Arizona lobbied hard for Arizona's "say-you're-sorry" law and believe it will help the problem.
"The record is clear - doctors who have a good bedside manner get sued far less than those who don't," said Dr. James Carland, CEO of the insurance company.
"There is no doubt about it - if the doctor is somebody you like, who talks to you, who cares about you, patients tend not to sue even when an error is made.
"We are definitely going to see more apologies from doctors in Arizona now, and we'll see hospitals set up seminars and training for how to do it. It will not be a landslide, it will not happen tomorrow, but it's going to happen."
Doctors themselves are not so sure of that, with many saying the new law will likely have little impact.
"My gut feeling, quite honestly, is I don't see doctor mea culpas all over the place because of this," said Dr. Thomas Scully, a Tucson neurosurgeon hit hard by rising insurance costs.
"Doctors who are open to patients, as they should be, do that now, but those who aren't probably won't start apologizing. In the long run, I don't think this is going to make much of a difference with the current liability crisis. It's going to take a lot more than that to rein in the system."
In his own practice, Scully has been sued only once in 12 years, by a prisoner whose complaint went nowhere - a great record for his high-risk specialty.
"But I can't say I've never made an error, that I've not made a mistake or done things that have not worked out well - absolutely, that has happened," he said.
"And I have clearly said to patients that I'm sorry, that this might not have come out as I wanted, or that I had done things not quite right. Has that prevented patients from suing me? That's a good question. I don't really know."
There is no doubt people daily flood the phone lines and offices of medical malpractice lawyers, wanting to sue their doctors over frivolous or at least fairly minor complaints, lawyers admit. "I get a lot of cases that don't have merit, but people want to sue because doctors treated them badly," said Tucson attorney Carter Morey.
"It is very clear to me that if a doctor can be upfront and decent, and his dealing with patients heartfelt and genuine, that's enough for a lot of people.
"They won't sue, even if there has been actual malpractice."
? Contact reporter Carla McClain at 806-7754 or at cmcclain@azstarnet.com. |
