| The simple fact is that bad things do happen to | | | | your insurance provider for guidance when an |
| good people and adverse medical events will | | | | adverse event occurs. However, research has |
| occur. Questions that must be addressed include | | | | shown that apologies without remorse are likely |
| what steps should be taken by the medical | | | | to be rejected, and that some patients will not be |
| provider and what does the patient expect from | | | | forgiving -- even after an acceptable apology with |
| the medical provider. | | | | remorse is given. |
| The jaded view might be that patients want | | | | An adverse event can often trigger an altruistic |
| compensation, so best to turn it over to the | | | | response on the part of the patient. They want |
| insurance company to handle. That statement is | | | | to proactively help prevent future mishaps |
| only half-right. Whenever an adverse event | | | | impacting the lives and health of others. |
| occurs, immediately contact your insurance | | | | We occasionally see this in situations involving |
| provider for guidance and direction. As for | | | | celebrities. Their efforts are focused on |
| compensation, patient expectations are not | | | | prevention and patient safety, as opposed to |
| always that simple. | | | | monetary compensation. |
| According to the Canadian Medical Protective | | | | A second and important expectation is that the |
| Association in responding to data presented in a | | | | medical professional accept responsibility and be |
| New Zealand study, the Canadian medical liability | | | | held accountable. Again this goes back to human |
| system provides responses in three areas: patient | | | | nature. An "I'm sorry" apology seldom holds as |
| safety, professional accountability, and litigation. | | | | much weight as one that accepts responsibility, |
| An article in the Journal of Healthcare Risk | | | | shows a willingness to be held accountable, and a |
| Management parallels the Canadian approach by | | | | firm desire to avoid reoccurrences. |
| indicating patient expectations centering on | | | | The final expectation is compensation. This can be |
| acknowledgement of the event, an apology, | | | | based on the personal financial needs of the |
| complete details about the incident, assurance that | | | | patient (seizing an opportunity) or can actually be |
| corrective measures have been taken, and | | | | the result of the response of the medical provider |
| compensation. | | | | and community to the event. |
| These, along with other expert opinions and | | | | For instance, consider a patient with an adverse |
| studies, seem to indicate that litigation and | | | | event. Concern is expressed, information shared, |
| compensation are not necessarily at the top of | | | | and corrective actions taken. The patient seems |
| the patient expectations list when it comes to an | | | | satisfied at that point. Then, shortly after |
| adverse medical event. Yet many providers | | | | returning home, the hospital and doctor bills begin |
| consider that to be at the top of their list and | | | | arriving. The patient feels that everyone is after |
| that can affect the attitude towards the patient. | | | | money for a procedure that went awry and |
| The reality is that the manner in which a | | | | required additional treatment for correction. At |
| healthcare provider manages communications | | | | that point, some patients will arch their back and |
| after an adverse event can determine the | | | | call their attorney to file suit. They feel that the |
| subsequent actions taken by the patient, including | | | | acceptance of responsibility was merely a verbal |
| formal complaints and litigation. | | | | response with a financial loophole. That is why |
| The initial reaction of most patients deals with the | | | | some medical centers take firm steps to ensure |
| inquisitive side of human nature. They want | | | | that a patient has no out-of-pocket expenses |
| acknowledgement of the incident and the | | | | related to an adverse medical event. |
| complete facts as understood by the medical | | | | Likewise if an investigation is conducted about an |
| provider. This is an area where patient and | | | | adverse event, keep the patient in the loop. They |
| provider can work together in sharing of | | | | want to know that demonstrable actions have |
| information about the event in order to better | | | | been taken to ensure that others will not suffer |
| understand contributing factors and the taking of | | | | the same fate. If you do not provide information |
| subsequent preventive actions to protect future | | | | on the results of the review and actions taken, |
| patients. Remember that acknowledgement of an | | | | they will feel that their experience has been for |
| event should also include empathy with the | | | | naught and may take further actions to take it |
| emotional feelings of the patient and family. | | | | public. |
| When it comes to an apology, there are differing | | | | All that being said, the one factor that will result in |
| schools of thought. Some say that an apology will | | | | a lawsuit faster than anything else is the |
| come back to haunt you in litigation; others say | | | | appearance of a "cover up" by what is perceived |
| that an apology can help defuse a litigatory event. | | | | to be the "medical establishment". |
| This is why it is critical to immediately contact | | | | |