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IN THIS EDITION:
- Why are angry patients and families so angry?
- Q&A Section
- Date conflicts?
- Heading to Texas
Why are angry patients and families so angry?
A central thesis or theme of The Sorry Works! Coalition is that anger - not greed - is what pushes most patients and families to file a medical malpractice lawsuit. This is truly not our thinking...it's been published countless times in the peer-reviewed medical literature over the last 10 to 15 years: anger is the primary reason patients and families file lawsuits!
When you except this truism then it shifts your thinking about fixing the med-mal problem away from politics (i.e, tort reform), the courts, and beating up trial lawyers to one of better customer service. How do we keep patients and families from becoming angry? But, you must first ask yourself, why do patients and families become angry?
Look at the relationship patients and families have with doctors and healthcare providers. It's a relationship that is built on trust. Think about it...people will share initimate details about their lives with doctors that they won't share with their spouses, parents, children, best friend, or minister. They will share the embarassing and even gory stuff with the doc so he/she can fix it, right? Absolute trust.
Furthermore, patients put their lives and well-being in the hands of healthcare professionals. Families entrust the lives of their loved ones to the doctor or nurse. "I entrust my _____ (wife, daughter, son, father, etc) to you, doctor. Please take good care of them. I love this peson and I can't imagine life without him/her."
That's powerful stuff. It's the dynamic we're dealing with....it's the highest level of trust that can be given to another person. Now, to a doctor or nurse, it may be just another patient or anxious family in the waiting room. But to the patient or family, it's the most important thing in the world, and they have placed their trust in the doctor(s), nurse(s), and technician(s) to take care of their loved one. It may be just another patient, but to this family it's the only grandpa they have...to these parents it's their first born child...to this husband it's the girl he fell in love with in college. You get the point. It's all about trust.
When adverse event happens (with or without error) and the healthcare professionals clam up, run away, and abandon the patient and family, that intimate trust is violated in a grotesque, ugly manner. Patients and families feel naked, stripped of all dignity, and abused. They have questions, but no answers or explanations are forthcoming. It's like your best friend or family member turning on you without explanation. Confusion abounds and it destroys you. And the natural human emotion is respond with anger.
"That damm doctor wouldn't return my calls...he just disappeared. As soon as something went wrong with Dad's care, it was like 'poof' he was gone. And those stupid nurses...they started covering up and making excuses, and after a while they disappeared too! The whole thing is a cover-up...I know they didn't something bad to Dad...I just know it!"
Sound familiar? That's real anger, and it's that anger that pushes patients and families to pick up the phone to call an attorney. Think about it....lawyers are the most despised profession in our country. As a rule, people generally hate lawyers....so patients and families have to be extremely angry to call one, right?
Ask any trial lawyer...he/she will tell you that the majority of people coming into their office over med-mal claims are angry and full of un-answered questions.
Anger, anger, anger....it's where the action is in med-mal. If you can mitigate and control anger, you're in great shape. But to do it you need to forget about the trial lawyers, politicians, and courts and focus on your patients and families. Sorry Works! is simply good customer service. Good customer service programs shine when the chips are down...when there's problems. Good customer service maintains or rebuilds trust with excellent communication and honest dealing. It fixes problems and keeps people from going to war with each other.
If you want to learn more about Sorry Works! and how its customer service focus can keep the lid on patient and family anger, give us a call at 618-559-8168 or drop us a line at doug@sorryworks.net.
Q&A Section
Welcome to this week's Q&A with Dr. Geri Amori, RM&PSI Senior Director (www.rmpsi.com) and former ASHRM president and Doug Wojcieszak, Founder and Spokesperson of The Sorry Works! Coalition (www.sorryworks.net).
Question: If we do Sorry Works! and go through all the steps (apologize, admit fault, explain what happened) and offer, for example, $300K, but the patient and trial lawyer counter-offer with $1 million, what do we do then?
Geri: Now I'm going to sound like a lawyer and not a counselor, but the answer is "That depends." If you believe that your offer fairly reflects appropriate and fair compensation, then your the next step is to decide how to manage the discrepancy. My temptation, as a humanist, would be to say something on the order of: "It appears that we are very far apart in our perspectives of what is fair in this event. Can you help us out by telling us more about what you see that contributes to the amount you are asking? " At that point, the patient and lawyer might say, "We're just angry" or "You should be punished," or they may have a legitimate concern that we have not considered. You can do one of three things at that point: 1) You can engage in conflict resolution skills yourself by looking for the areas you agree upon, then finding ways to satisfy both your needs for fair treatment; 2) You can see if they are willing to work with a trained mediator to help resolve your differences in opinion; or, 3) you can suggest they may need to pursue litigation.
Adopting Sorry Works! does not mean that you fold to any demand. It does, however, mean that you approach errors humbly, honestly, and with the intent of doing what is right and fair. Just as not all providers are the same, not all patients are able to be fair. Sometimes emotion clouds the ability to forgive, or even negotiate. Many people take situations where they feel helpless personally, eliciting the need for revenge and punishment. The Sorry Works! Approach is not about avoiding litigation, it's about offering humbly to be fair. Sometimes it won't work. Nevertheless, you will never lose. Even if the situation goes to trial, jurors recognize the efforts made by providers to do the right thing. You may spend money, but your reputation and integrity remain intact. There is no number that can be attached to that!
Doug: Geri gave a great answer. To borrow a quote from Dr. Steve Kraman and Rick Boothman, Sorry Works! is "compassion with a backbone." You don't hand out money like its water. You be fair, but firm. As Geri said, try to understand where the patient/family and their attorney are coming from...why they think the claim is worth a $1 million. Try to find common ground, and also work through their anger and other emotions. However, at the end of the day, if the two sides can't agree you go to court as the last resort (and isn't that what the courts are supposed to be...a place of last resort?!). And you walk into court with a great defense as an honest, open defendant who has tried to do the right thing. It will be very hard for a jury and judge to angry at you and finacially punish you. In fact, ask any trial lawyer and he/she will tell that an honest defendant is nearly impossible to prosecute. Trial lawyers like defendants who are lying and covering up.
All that said, the general experience for facilities with disclosure and apology programs is that they find anger among patients and families is greatly diminished, and when anger is off the table reasonable people can come to terms on what is fair and right in a short period of time.
Got a question? Write to gamori@rmpsi.com or doug@sorryworks.net - your identify will remain confidential. Thanks!
Date Conflicts
Tuesday November 14 is a big day for us...it's the date of our first nationwide audio conference. And we know many of you are planning to join us. However, we realize that some folks have scheduling conflicts or may have even registered for another audio conference on the same date and time. No problem! We will be offering CDs of the conference. To get your CD, simply contact Melanie Gober at 517- 886-8226 (phone), (517) 327-4604 (fax), or e-mail: mgober@rmpsi.com. Thank you!
Heading to Texas
This week Sorry Works! will be heading to Austin, Texas to speak to at a retreat organized by the Baylor University Medical Center. While in Austin, we will be having two additional private meetings that we hope will become public knowledge in the not-to-distant future. Stay tuned.
If you are interested in a Sorry Works! speaker, contact doug@sorryworks.net or call 618-559-8168
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