Questions from the Road: Premature Apology?

April 7, 2011Doug Wojcieszak, Founder & Spokesperson Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net

QUESTIONS FROM THE ROAD - PREMATURE APOLOGY?

Last week, Sorry Works! made two presentations in California, one in Los Angeles with the Hospital Association of Southern California, and the other in Napa, CA for a large med-mal insurer. Both great audiences, and some great questions from the audiences I want to share with you over the next few days.

Question from Napa: "It seems some of our insured docs don't understand the differences between empathy and apology. Some of the docs in their verbal and written statements go too far with patients and families by seeming to admit fault, when in fact they simply need to empathize. And when the investigation shows NO mistake occurred, it makes it very hard to go back to the patient or family. What do we do?"

Three thoughts: 1) Keep training; 2) Build awareness; 3) Don't panic!

We need to keep training our docs and front-line clinicians on empathy, and the differences between empathy and apology. It's all about context...."We are sorry this happened , and we feel bad for you....we are going to investigate what happened and touch base with you at 3pm tomorrow afternoon." That's text-book empathy - and we need to keep teaching it.

But we need to focus on the greater/bigger goal of building awareness about disclosure. When I'm talking about awareness I'm speaking to the fact that the doc or nurse we train today may need this stuff 3 years, 2 months, and 6 days down the road...and gee golly wiz, the doc may just forget the finer points of empathy vs. apology, and what exactly to do if confronted by a family member who claims that a nurse told them a mistake occurred. We hope no clinician become an expert in disclosure! But, our front-line docs and nurses should never forget that disclosure is an expectation of the organization and be able to contact someone from the disclosure team, risk, legal, claims, etc before doing that initial contact and empathy with the patient or family. Awareness is so important!

But don't panic. Sometimes people use the story of the doc that went too far in disclosing, or the disclosure that still led to a lawsuit as "Aha, see it doesn't work" or "We're not ready for this!" Sure, there will be times when docs go too far, and the situation will have to be recovered. But this beats the alternative: Telling docs to keep quiet and cover up. We know where that goes! Seriously folks, there is no going back. Disclosure is today and our future.

Conversely, there will be times that docs do empathy perfectly, but the patient or family will misunderstand. But, you know what? There is no misunderstanding a cover up. No misunderstanding phone calls or e-mails not returned. Meetings cancelled, etc. There is no going back!

And keep this in mind: For every time you hear about disclosure supposedly not working, think about all the times disclosure works but you don't hear about it!

We must train our people and we must raise awareness, but we also must keep in the mind the view from 35,000 feet. Disclosure is not perfect, there will be times docs don't do it right and/or patients & families don't understand, but, in general, from the perspective of a hospital or a pool of insureds, you're better off doing disclosure versus deny & defend. Much better off. Overall, litigation, settlement costs, and associated litigation costs will drop, while patient safety and staff satisfaction & retention will increase. Not every lawsuit will be stopped (for a variety of reasons), but many lawsuits will be halted, and the size of settlements will also drop. Because for every doc that goes too far in empathy, there are many more instances where anger is quelled and litigation avoided with a well-placed sorry.

For more information on Sorry Works!, including Sorry Works! presentations and disclosure training, please call 618-559-8168 or doug@sorryworks.net.

Sincerely,

- Doug

Doug Wojcieszak, Founder Sorry Works! PO Box 531 Glen Carbon, IL 62034 618-559-8168 (direct dial) doug@sorryworks.net (direct e-mail)