The Sorry Works! The Sorry Works! CoalitionCoalition

QuotablesQuotables

““I would never introduce a doctor’s I would never introduce a doctor’s apology in court. It is my job to apology in court. It is my job to make a doctor look bad in front of a make a doctor look bad in front of a jury, and telling the jury the doctor jury, and telling the jury the doctor apologized and tried to do the right apologized and tried to do the right thing kills my case.”thing kills my case.”

- President, South Carolina Trial - President, South Carolina Trial Lawyers Assoc. Lawyers Assoc.

QuotablesQuotables ““For decades, lawyers and risk managers For decades, lawyers and risk managers

have claimed that admitting responsibility have claimed that admitting responsibility and apologizing will increase the likelihood and apologizing will increase the likelihood of a patient filing a malpractice suit and be of a patient filing a malpractice suit and be used against a doctor in court if they sue. used against a doctor in court if they sue. However, this assertion, which seems However, this assertion, which seems reasonable, has no basis in fact. There is reasonable, has no basis in fact. There is to my knowledge not a shred of evidence to my knowledge not a shred of evidence to support it. It is a myth.”to support it. It is a myth.”

- Dr. Lucian Leape, Harvard University in - Dr. Lucian Leape, Harvard University in the March/April 2006 issue of The the March/April 2006 issue of The Physician Executive Physician Executive

QuotablesQuotables

““We never sue the nice, contrite doctors. We never sue the nice, contrite doctors. Their patients never call our offices. But Their patients never call our offices. But the doctors who are poor communicators, the doctors who are poor communicators, arrogant, and abandon their patients get arrogant, and abandon their patients get sued all the time. Their patients call our sued all the time. Their patients call our offices looking for answers.”offices looking for answers.”

- David Patton- David PattonMedical malpractice attorney and Medical malpractice attorney and

Sorry Sorry Works! board member Works! board member

QuotablesQuotables

““Our profession made a grave error Our profession made a grave error when we listened to defense when we listened to defense attorneys who told us to abandon our attorneys who told us to abandon our patients after adverse events. This is patients after adverse events. This is the chief reason we have a medical the chief reason we have a medical malpractice crisis.”malpractice crisis.”

- Dr. Jerome Buckley- Dr. Jerome Buckley Retired CEO of COPIC Ins. Retired CEO of COPIC Ins.

Brief background on Brief background on The Sorry Works CoalitionThe Sorry Works Coalition

Formed in February 2005Formed in February 2005 Diverse board representing all Diverse board representing all

stakeholders in the medical stakeholders in the medical malpractice crisismalpractice crisis

Advocate apologies and upfront Advocate apologies and upfront compensation as “middle ground” compensation as “middle ground” solution to crisissolution to crisis

Our beliefOur belief

The Sorry Works! Coalition believes The Sorry Works! Coalition believes and advocates that apologies and and advocates that apologies and upfront compensation for medical upfront compensation for medical errors reduce lawsuits and liability errors reduce lawsuits and liability costs while providing swift justice for costs while providing swift justice for more victims and reducing medical more victims and reducing medical errorserrors

Goals of the CoalitionGoals of the Coalition

Goal #1: EducationGoal #1: Education

Goal #2: Organizing the full-disclosure Goal #2: Organizing the full-disclosure movementmovement

Goal #3: Legislative activities, Goal #3: Legislative activities, including Sorry Works! pilot including Sorry Works! pilot programs, mandated training, etc.programs, mandated training, etc.

Educational messageEducational message

Sorry really does Sorry really does workwork! ! Lexington VA hospital/all VA hospitalsLexington VA hospital/all VA hospitals University of Michigan/Stanford University, University of Michigan/Stanford University,

and Harvard Teaching Hospitalsand Harvard Teaching Hospitals Kaiser hospitals (28 hospitals)Kaiser hospitals (28 hospitals) Minneapolis Children’sMinneapolis Children’s Catholic Healthcare West (40 hospitals)Catholic Healthcare West (40 hospitals) COPIC InsuranceCOPIC Insurance And others…. And others….

Program descriptionProgram description

Bad outcome – unexpected death, surgery Bad outcome – unexpected death, surgery or treatment did not produce expected or treatment did not produce expected results, etcresults, etc

Root cause analysis – several weeks to Root cause analysis – several weeks to four months – was the standard of care four months – was the standard of care met? met?

Stay in close contact with patient/family Stay in close contact with patient/family during analysis– return all phone calls during analysis– return all phone calls promptly and pleasantlypromptly and pleasantly

Program description cont’dProgram description cont’d

Root cause analysis shows standard Root cause analysis shows standard of care not met = error(s) or of care not met = error(s) or negligencenegligence

Set meeting with patient/family and Set meeting with patient/family and attorneyattorney

Apologize and admit faultApologize and admit fault Explain what happened and fixExplain what happened and fix Offer upfront compensationOffer upfront compensation

Program description cont’dProgram description cont’d

Root cause analysis shows standard Root cause analysis shows standard of care was met = no error(s) or of care was met = no error(s) or negligencenegligence

Still meet with patient/family and Still meet with patient/family and attorneyattorney

Empathize, answer questions, open Empathize, answer questions, open records – prove innocencerecords – prove innocence

““Honesty Dividend”Honesty Dividend” RUSH variationRUSH variation

Sorry Works! SavingsSorry Works! Savings

Anger reduced = fewer lawsuits, Anger reduced = fewer lawsuits, lower settlementslower settlements

Defense litigation costs down; cases Defense litigation costs down; cases closed in months instead of yearsclosed in months instead of years

Non-meritorious cases reducedNon-meritorious cases reduced Medical errors reducedMedical errors reduced Happy patients and families don’t Happy patients and families don’t

bad mouth hospital bad mouth hospital

Addressing doubtersAddressing doubters

Docs will become sitting ducksDocs will become sitting ducks Saying sorry is admitting faultSaying sorry is admitting fault Trial lawyers are too Trial lawyers are too

aggressive/courts really awfulaggressive/courts really awful Small cases – not big casesSmall cases – not big cases Settling and paying cases we could Settling and paying cases we could

win in court??win in court??

Important PointImportant Point

““Sorry” alone doesn’t workSorry” alone doesn’t work Admitting faultAdmitting fault Fixing procedures important and Fixing procedures important and

possibly involving patient/family in possibly involving patient/family in the processthe process

Upfront compensation Upfront compensation

““Snow jobs and weasel words”Snow jobs and weasel words”

““I shouldn’t be you telling this, but…”I shouldn’t be you telling this, but…” ““I’m sorry this happened to you…”I’m sorry this happened to you…” ““We feel horrible about this….”We feel horrible about this….” ““We’re sorry if you feel that way…”We’re sorry if you feel that way…” Make patients and families angrier – Make patients and families angrier –

increase likelihood of lawsuitincrease likelihood of lawsuit Don’t do it!!Don’t do it!! Need carefully planned, well-thought out Need carefully planned, well-thought out

disclosure events; training needed. disclosure events; training needed.

Legal problem? No.Legal problem? No.Customer service problem? Yes!Customer service problem? Yes!

Med-mal crisis is really a customer Med-mal crisis is really a customer service crisisservice crisis

Legal reform not the answer – Legal reform not the answer – enhanced communication, problem enhanced communication, problem solving, and rebuilding trust through solving, and rebuilding trust through programs like Sorry Works! the programs like Sorry Works! the answer.answer.