Life seems so complicated, yet in the final analysis it's often fairly simple. All of us have been the reluctant recipients of the wisdom our parents and grandparents tried to pass on. It wasn't that we didn't believe them or didn't respect what they had to say, but too often we didn't really pay attention because we were too busy with other things. Or maybe we thought we knew better. But as we grew older, a lot what they had to say started to make sense-simple advice like the importance of practicing good manners, always telling the truth and always showing others the respect they deserve. As the years pass, we take many of those old homilies to heart and even begin preaching them to our own children.
I don't know anybody who doesn't want to be treated with dignity and respect. When we realize someone has told us a lie or has attempted to cheat us, it's human nature to become furious about such treatment. But somehow we have entered an era when telling the truth is considered a quaint notion or seemingly unnecessary if one can get away with a deception or transgression. By today's standards, it seems being caught in a lie is the sin, not the lie itself. In this litigious age, it's the custom to deny any culpability, any involvement in whatever has gone wrong, even though others may have pictures or other proof of your guilt or association.
As I read the Wall Street Journal last Tuesday, a story on the front page caught my eye and raised many of these moral and ethical issues. The story, headlined "Medical contrition: Doctors' new tool to fight lawsuits," involved medical errors, malpractice lawsuits and physician behavior. It's the stuff that puts the fear in any healthcare executive's heart, especially with all the media hoopla about healthcare quality these days. The story's message was direct, pointing out the rewards that can accrue when a physician or healthcare organization decides to come clean when a medical error is committed, and the simplicity of the idea is itself an eye-opener. The payoff can be significant, perhaps saving hundreds of thousands, if not millions of dollars in malpractice damages. That alone should get everyone's attention.
The healthcare industry has been reeling for years over the large awards given to those who sue a physician, a hospital or both over medical errors. Many physicians have left their practice because of the high insurance premiums they have to pay to continue practicing medicine. The article in the Journal started with the story of a 41-year-old mother of three, Linda Kenney, whose heart stopped while she was having routine ankle surgery. The reason this occurred was because the attending anesthesiologist, Frederick van Pelt, inadvertently injected a pain-killing medication into the wrong place. To get the woman's heart restarted, doctors at Brigham and Women's Hospital in Boston had to open her chest and crack her rib cage. Kenney's husband was beside himself when he found out what happened and, according to Linda Kenney, "wanted to kill the anesthesiologist, flatten him." But something happened that changed everything. Van Pelt wrote her a personal letter saying he was "deeply saddened" by her suffering. Later, according to the article, van Pelt had coffee with Kenney and apologized to her personally for the terrible mistake, even though the hospital had advised him not to do so. Here's Kenney's reaction to the apology: "I found out he was a real person. He made an effort to seek me out and say he was sorry I suffered." Because of the doctor's actions, the Kenneys dropped plans to sue.
Over the past few years it has been standard practice for hospital lawyers to discourage physicians from apologizing to harmed patients out of fear that they might turn around and sue. But that thinking seems to be changing, prodded by incredibly higher malpractice premiums and a patients' rights movement that is pushing for full disclosure of medical errors. The old way was to "defend and deny," and that's just about what everyone used to do. But there seems to be some new thinking. For instance, according to the article, since 2001 a number of high-profile institutions including Johns Hopkins Hospital in Baltimore and Dana-Farber Cancer Institute in Boston, along with others, have made it policy to urge their physicians to own up to their mistakes and formally apologize. At least two states, Colorado and Oregon, have passed laws saying an apology can't be used against a doctor in court. A Colorado surgeon, Michael Woods, even suggests that an "authentically" offered apology is one of the most effective ways to reduce physician liability.
In another case cited in the article, a 50-year-old man who underwent surgery for colorectal cancer developed serious complications about two weeks after the procedure and was astounded to find out that his doctors had left a sponge inside him. When the error was discovered, the surgeon told the patient, "No matter how this happened, I was the surgeon in charge; I was the captain of the ship and I was responsible and I apologize for this." Later an executive of Sharp HealthCare in San Diego, operator of the hospital involved, also apologized. The patient was so impressed with the honesty and candor of the hospital he didn't even hire a lawyer. The hospital settled directly with him for an undisclosed amount. The patient stated, "They honored me as a human being."
Of course, the issues of medical errors and medical malpractice are complex and often involve consequences that a simple apology cannot resolve. Nobody is saying an act of contrition will solve everything, but something is brewing here that just might help chip away at some destructive and debilitating problems plaguing our industry. A large dose of honesty from all parties involved might just save everyone a lot of time, money and stress and bring dignity, confidence and respect back into the picture.
Grandmother knew best,