"Sorry" Leads to Lawsuits?
May 27, 2011Doug Wojcieszak, Founder & Spokesperson Contact phone/e-mail address: 618-559-8168; firstname.lastname@example.org
"SORRY" LEADS TO LAWSUITS During my last road trip, I got hit with the following questions:
"What if the patient or family misconstrues "sorry" as an admission of guilt?"
"What if the patient or family doesn't suspect anything, and by disclosing and saying "sorry" we're buying ourselves a lawsuit vs. if we had kept our mouths shut and said nothing we would be in the clear?"
"By going to funeral am I implying I did something wrong....maybe a guilty conscience? Could this lead to a lawsuit?"
I can imagine the response of some of our readers concerning ethics, morality, and legal obligations....."Hope you were outraged at these stupid questions, Doug!"
The docs who asked these questions appeared to be sincere individuals struggling with this difficult topic of disclosure. Remember what we've done to our docs and nurses: Told them for decades to shut up and hide when something goes wrong, and now we expect them to spin on a dime and be honest, open, and contrite....and be good at it!! Hah!
We need to help our people think through these difficult situations.
The easy answer to these questions is "Doctor, where are your ethics? What are your moral obligations to your patients and families?" But, like most easy answers, this response is really not optimal or realistic for people trying to implement disclosure. Indeed, such a dismissive retort will undermine and ultimately kill your disclosure efforts. Docs and nurses operate in a high-stakes environment filled with land mines, and all too often they get blamed for things that are not their fault. So, we need a better response. Try this:
"Doctor, you have some legitimate fears and concerns --- and let's try to work through them, OK?
Doctor, at the minimum, disclosure is about building strong evidence for a great defense. Defensible medicine will be defensible, and errors will lead to a fair discussion of just compensation as opposed to an angry fight over money.
When an adverse event happens, you need to talk to your patients and families. You need to be empathetic, and if an investigation warrants, apologetic. But don't apologize before the investigation is complete!
You need to practice good customer service skills. Sometimes going the extra mile - such as attending a funeral - will feel like the right thing to do. Do it!
Shutting down communication and breaking off relationships with patients and families leads to anger and hurts feelings and litigation in many instances, including non-meritorious litigation because the doctor looked and acted guilty (even when the standard of care was not breached!)
Using the techniques of Sorry Works! will defuse many situations, even when serious harmed was caused by malpractice. However, in those instances where the situation is not defused for whatever reason (including the family misunderstanding the "sorry" as an apology when it was simply empathy), then the evidence created in the disclosure process will make the case defensible.
Disclosure is not only the right thing to do, it's the intelligent thing to do on multiple fronts: risk/litigation, quality & safety, job satisfaction, and emotional health of clinicians.
The best way to mitigate your legitimate fears of disclosure is with training. Let's get you and your peers trained to harness the amazing potential of disclosure. Disclosure is not only good for patients and families, it's great for clinicians too."
You have to acknowledge the fears of your physicians, nurses and other staff, and help them work through these fears in an intelligent fashion. Simply yelling about ethics is not the answer....if we want people to "buy it" we need to earn their loyalty and trust, and we do so by validating their fears and addressing them in a respectful fashion.
For more information on Sorry Works! presentations and training seminars, call 618-559-8168 or e-mail email@example.com.
Doug Wojcieszak, Founder Sorry Works! PO Box 531 Glen Carbon, IL 62034 618-559-8168 (direct dial)