Admit your mistakes, offer remuneration; be forgiven.
That’s the lesson emerging from a new malpractice claims management policy in Michigan published in the Annals of Internal Medicine August 17 issue.
In the study, claims and compensation requests for errors from 1995 to 2007 filed against the University of Michigan Health System were reviewed.
Because the health system instituted a comprehensive claims management program in 2007, a before-versus-after analysis could be conducted.
Under the new program, all medical errors were disclosed along with an offer of compensation whereas, previously, they had been assigned to a defensive lawyer.
You would think that this new system of disclosure-plus-compensation might cause patients to file a lawsuit in hopes of getting more.
Not so. There were fewer lawsuits and claims and lower costs. Claims that were filed were resolved more quickly; and lawsuits were less expensive overall as well as the amounts of the awards, too.
In fact, the average monthly rate of lawsuits dropped 65%. Claims dropped 35%, and median claim resolution time dropped 30%. Costs per lawsuit fell 38%, while total spending on legal defense dropped a whopping 61%.
This certainly looks promising. It might even provide a direction for the future of medical malpractice lawsuits and escalating cost prevention—particularly in light of Los Angeles County news that their medical malpractice payouts increased 50% between 2005 and 2007 (from about $8 to $12 million) at the same time that the number of incidents decreased. So anything that lowers the ultimate cost should be given heavy consideration.
But how does it apply to other members of the healthcare sector, namely physicians and physician groups? Can the same results be achieved if implemented by these other types of healthcare providers?
Simply put, under the current patchwork system it would be next to impossible. The University of Michigan Health System is a unified system—unlike much of the fragmented health system in the United States. Elsewhere, the water is murky.
Let’s say you advise surgery for a patient, and while your patient is in the hospital, a nurse or even the anesthesiologist administers the wrong medication (mistakes related to administering medicine are one of the most common medical errors). Is that your fault or hers?
Most likely, both insurance companies would have to get involved in the claim to rule out physician liability and properly assign fault.
Conceivably, too, hospitals have less risk involved in implementing the disclosure-and-offer strategy. First, they have a wider patient base and a more diversified source of revenue. With a single physician, one lawsuit gone awry can sink him or her.
But how much should you really worry about a medical malpractice lawsuit?
It depends on who you are.
The Bureau of Justice Statistics analyzed lawsuits in the nation’s 75 largest counties. Only 33% of lawsuits are brought against non-surgeons. Nine out of 10 suits filed are the result of a permanent injury or death.
However, primary care physicians are still vulnerable. In fact, they are the hardest hit when it comes to malpractice claims from heart attack misdiagnoses.
According to a Physician Insurers Association study, $91 million in claims were made on 349 heart attack cases in the period studied. Family physicians had the highest number of claims filed, while internists had the highest average payout of $252,100. Heart attacks are notoriously hard to diagnose, and the symptoms can mirror those of other diseases.
So when it comes to adopting a new disclose-plus-offer strategy, should you or shouldn’t you? Only you can decide, based on your risk and exposure. - Jen Gilbert
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