During the past 10 years that I’ve been advocating for patients in medical malpractice claims, I have seen this time and time again – my clients are the ones that were reasonable patients but ended up needing an attorney because they had a doctor who committed some type of harm on them and then tried to cover it up, deny that it occurred or worse, blame the patient for the harm. If the physician had admitted to the mistake and provided some type of compensation to address the additional care they needed for the harm – they would have never walked through our doors. I know there are many medical malpractice attorneys who would agree with me. Thus, I smiled when I happened upon an article recently that explained this approach and how it has decreased medical malpractice claims at a drastic rate.
The University of Michigan Health System doesn’t claim to be perfect. But its response to medical errors, near-misses, unexpected clinical problems and unintended outcomes is a model for the nation that other hospitals can and should copy. In a paper in December issue of the Milbank Quarterly, and in a presentation recently at a meeting of the U-M Board of Regents, the UMHS approach is in the spotlight for its potential to be emulated by hospitals across the country.
Read More: The Basics of a Medical Malpractice Claim
“By handling unanticipated and unintended incidents, and patient injuries, honestly and proactively, we’ve virtually eliminated groundless legal claims, allowing us to focus on issues that demand attention with clear vision and no more excuses,” says Rick Boothman, executive director of clinical safety at UMHS. “We fundamentally focus on putting patients and safety first, and we believe other hospitals can do the same.” Darrell A. Campbell, Jr., M.D., chief medical officer at UMHS, and Boothman have led a decade-long effort to implement and measure the results of the Michigan Model.
It’s based on these key principles:
In that decade, new malpractice claims per month have dropped, total liability costs have dropped, claims and potential claims are being resolved faster, and UMHS is increasingly avoiding litigation in both claims without merit and claims with merit. The authors of the paper find a general consensus that the Michigan approach – also called DA&O for “disclose, apologize and offer” — holds great potential to improve medical liability and patient safety.
“It was viewed as more promising than any other liability reform option, both on its merits and because it would not be stymied by political gridlock in state legislatures, as other tort reforms frequently have been.” They also note that it offers a “value proposition” to patients that’s crucial in this age of federal health care reform. They conclude DA&O programs may prove not only to constrain liability costs but also to improve access to compensation, strengthen linkages between the liability system and patient safety, increase health care organizations’ accountability and patient advocacy, and promote transparency in regard to medical error.
Boothman notes that the Michigan Model or DA&O has also been put forth as a model by the federal Agency for Health Care Research and Quality, which has issued grants for teams to study implementation of the Michigan Model as the leading response to the malpractice crisis.
University of Michigan is not the only hospital system that has implemented this approach and seen success and a drop in malpractice claims. The number of malpractice filings against the University of Illinois has dropped by half since it started its program, said Dr. Timothy B. McDonald, the hospital’s chief safety and risk officer. In the 37 cases where the hospital acknowledged a preventable error and apologized, only one patient has filed suit. Only six settlements have exceeded the hospital’s medical and related expenses.
I hope this approach spreads like wildfire and hospitals, physicians, and all healthcare providers take notice. I think the three words of “I am sorry” will go a lot farther than health care providers, insurance companies and defense attorneys think. To err is human – sometimes you just need to admit it.