Disclosure Pro Tip: Poor Prognosis Patients

Many years ago, a physician friend told me that sometimes the best doctors are clinicians with many lawsuits filed against them. My friend explained that highly skilled physicians can take on patients with poor prognosis because they may be the only hope for these very ill/injured consumers.  Perhaps the doc can perform a miracle, perhaps not, yet when the result is not a happy one litigation may ensue, stated my MD friend.  I countered that any doc with lots of lawsuits has something wrong their practice, even if they are practicing in a heroic fashion.

During a recent Sorry Works! training session for a large hospital system, a cardiologist re-visited this topic with me. The cardiologist shared that he often receives referrals for extremely sick patients who need dramatic -- even heroic -- interventions, and the chances of success are usually not high in many of these cases which can lead to litigation, complaints to regulatory officials, and even nasty social media posts.   "If I don't act it's typically a death sentence for most of these patients, yet I am potentially exposing myself to increased liability," stated the cardiologist.   

I gave a multi-faceted response to the cardiologist.  First, I shared that in my experiences in working with physicians there too often seems to be an embarrassment factor when care plans do not produce the desired result, even in cases with a low probability of success. The mere presence of the patient and family in such cases is a reminder that the heroic surgeon is actually not superman or superwoman, and the stench of failure/defeat can literally drive doctors away from patients and families. I told the cardiologist that patients and families need you, especially when things don't work out despite your best efforts. Don't let patients and families feel abandoned. Second, I reminded the cardiologist that care is not just about medicine, science, and technology.  The best care plan can primarily entail emotional support, being empathetic, and being a present for a patient and his/her family during difficult moments. Moreover, the care for patients and families doesn't stop when the medicine is of little to no use.  This is why, for example, we have recommended sending sympathy cards, attending funerals or wakes, and calling family members. Furthermore, it can be just as beneficial to provide emotional care for chronically ill or dying patients and their families.  Being a physician means being there even when the technology and pharmaceuticals are of no use.  Maintaining and strengthening relationships with poor prognosis patients -- no matter the outcome -- will lessen the chances of litigation, regulatory complaints, and nasty social media posts.  It's hard to sue somebody or complain when that person has been a great friend during the worst moments...  

Sorry Works! has been in the business of teaching disclosure to front-line clinical staff & leadership in acute and long-term care organizations longer than anyone -- and our prices are the lowest in the industry.  To learn how we can help your organization embrace disclosure, give us a call at 618-559-8168 or e-mail doug@sorryworks.net.

Sincerely,

- Doug

Doug Wojcieszak, Founder and President
Sorry Works!
618-559-8168 (direct dial)
doug@sorryworks.net