Saying 'sorry' pays off for U. of Michigan doctors

Jul 20, 2009 By DAVID N. GOODMAN , Associated Press Writer
Dr. Joan Reede, right, and her mother Tommye Reede, who was a medical malpractice victim, pose together for a portrait in Hull, Mass. on Friday, July 10, 2009. (AP Photo / Greg M. Cooper)

(AP) -- When a treatment goes wrong at a U.S. hospital, fear of a lawsuit usually means "never daring to say you're sorry."

That's not the way it works at the University of Michigan Health System, where lawyers and doctors say admitting mistakes up front and offering compensation before being sued have brought about remarkable savings in money, time and feelings.

"What we are doing is common decency," said Richard Boothman, a veteran malpractice defense lawyer and chief risk officer for a health system with 18,000 employees and a $1.5 billion annual budget.

The estimated $5.8 billion annual cost of malpractice claims nationwide has drawn scrutiny as President Barack Obama and Congress plot an overhaul of the nation's $2.4 trillion health care system. So far, Obama has spoken in broad terms about shielding doctors from unwarranted lawsuits without capping damage awards, but medical malpractice is an issue that deeply divides. Doctors, hospitals, trial lawyers and patient advocates disagree not only on the solution but the problem itself.

Is it the high price of malpractice insurance? The difficulty for victims of medical errors getting justice? The cost of unneeded tests ordered by lawsuit-wary doctors? The "burying" of medical errors that kill tens of thousands of Americans yearly?

Officials at the University of Michigan say their approach addresses doctor, patient and public concerns.

The willingness to admit mistakes goes well beyond decency and has proven a shrewd business strategy, according to a 2009 article in the "Journal of Health & Life Sciences Law" by Boothman and four colleagues at the Ann Arbor school.

According to Boothman, malpractice claims against his health system fell from 121 in 2001 to 61 in 2006, while the backlog of open claims went from 262 in 2001 to 106 in 2006 and 83 in 2007. Between 2001 and 2007, the average time to process a claim fell from about 20 months to about eight months, costs per claim were halved and insurance reserves dropped by two-thirds.

Boothman said the health system learns of possible medical errors from doctors themselves, as well as from patients or their lawyers. In any case, the university conducts a peer review to see if there was an error and if changes are needed to prevent a recurrence.

Equally important, health system doctors and officials offer to meet with patients and their families, sometimes to explain that treatment was appropriate and sometimes to admit a mistake.

"I do believe caregivers want to do this," said Boothman, whose second-floor office looks out on the University Hospital at the heart of the sprawling medical center, 35 miles west of Detroit. "It's not a hard sell at all, as long as you can reassure them it's OK."

Malpractice lawyer Norman Tucker has several active cases against the University of Michigan and said the school is fair, though not an easy mark. Lawyers say because Michigan admits mistakes in some cases, it can signal a tough fight ahead in those cases where it denies error.

"You should follow Mark Twain's advice: `When in doubt, tell the truth,'" Tucker said.

According to Harvard Medical School Dean Dr. Joan Reede, patients and their families can find great relief and comfort when a doctor promptly admits an error. She learned this personally when her mother nearly died from a medical error in 1998.

Tommye Reede of Hull, Mass., spent eight weeks in a hospital after hip surgery when doctors at first failed to spot a severe allergic reaction despite warnings from her medically trained daughter.

"There was an apology from the surgeon," Joan Reede said. "There was an acknowledgment that `I did not pay attention.' ... At no point did I feel abandoned."

"When you get what you consider to be a sincere apology, you always feel better," said her mother, now 79, who didn't sue.

Mother and daughter talked about the experience in a 2006 doctor training DVD "When Things Go Wrong" by Dr. Tom Delbanco of the Harvard Medical School. They declined to name the hospital, saying they didn't want to single it out for attention.

The openness approach is catching on at places from Boston Medical Center to the University of Illinois to California's Stanford University hospital.

"Apologies for , along with upfront compensation, (reduces) anger of patients and families, which leads to a reduction in medical malpractice lawsuits and associated defense litigation expenses," according to Doug Wojieszak, spokesman for The Sorry Works! Coalition. The group includes doctors, lawyers, insurers and patient advocates.

The "saying sorry" movement has its skeptics, even among those who agree it's the right thing to do.

The right of injured patients to sue providers and force them to open up their internal records is a crucial part of reducing medical mistakes and improving care, said Matthew Gaier, co-chairman of the New York State Trial Lawyers Association's medical malpractice committee.

Harvard University public health associate professor David Studdert says a review of published studies shows about 181,000 people are severely hurt each year as a result of mistakes at U.S. hospitals but only about 30,000 file legal claims.

Many people don't sue because they don't discover they're victims of malpractice, Studdert and colleagues wrote in a 2007 article in the journal "Health Affairs." The spread of disclosure, the article said, could cause malpractice costs to rise from $5.8 billion now to between $7 billion and $11.3 billion a year.

For "saying sorry" to work, doctors need protection from having their own honesty used against them in court, said Jim Copland, director of the Manhattan Institute's Center for Legal Policy and an advocate of curbs on damage suits. Protection could take the form of a shield law that would exclude an apology from admission as evidence in a malpractice suit. A number of states have or are considering such laws.

"If you go out and say, `Oh, we messed up, are you going to lose the lawsuit? You need to give them some protection," Copland said.

©2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Explore further: How to keep your fitness goals on track

add to favorites email to friend print save as pdf

Related Stories

Hospitals offer new take on medical mistakes

Mar 08, 2009

All Donald Platt wanted was an apology. The tumor on his kidney was the size of a baseball by the time his cancer was detected in a CT scan - five years after his doctor misdiagnosed his symptoms and failed to order the right ...

Malpractice caps lure docs to Texas

Oct 05, 2007

Medical malpractice award caps in Texas have swollen the ranks of medical specialists and license applications at the state medical board, official said.

Electronic health records may lower malpractice settlements

Nov 25, 2008

Use of electronic health records (EHRs) may help reduce paid malpractice settlements for physicians, according to a new study. The study, which appeared in the November 24 issue of Archives of Internal Medicine, showed a tren ...

Suit against health insurers dismissed

Jun 20, 2006

A 7-year legal battle against U.S. health insurers filed by doctors has ended with the dismissal of all remaining claims by a U.S. District Court in Florida.

Recommended for you

AMA examines economic impact of physicians

2 hours ago

(HealthDay)—Physicians who mainly engage in patient care contribute a total of $1.6 trillion in economic output, according to the American Medical Association (AMA)'s Economic Impact Study.

Less-schooled whites lose longevity, study finds

2 hours ago

Barbara Gentry slowly shifts her heavy frame out of a chair and uses a walker to move the dozen feet to a chair not far from the pool table at the Buford Senior Center. Her hair is white and a cough sometimes interrupts her ...

How to keep your fitness goals on track

2 hours ago

(HealthDay)—The New Year's resolutions many made to get fit have stalled by now. And one expert thinks that's because many people set their goals too high.

Suddenly health insurance is not for sale

Apr 18, 2014

(HealthDay)— Darlene Tucker, an independent insurance broker in Scotts Hill, Tenn., says health insurers in her area aren't selling policies year-round anymore.

User comments : 2

Adjust slider to filter visible comments by rank

Display comments: newest first

not rated yet Jul 21, 2009
I might sound cynical but I find this article to be totally and completely untrue. In my experience with UMH they not only were incompetent, neglectful and uncaring, they tried to lie and deny the events that occurred!The only one they protect is the doctor. The patient is expendable!
not rated yet Jul 29, 2009
Read this story. Boothman did not apologize to this family. The Hereford family is owed an apology, instead Boothman adds insult to injury. It would be interesting to see the number of cases that Boothman and his hospital admit a mistake and make a genuine apology.


Seems to me this is a brilliant PR strategy by Boothman and the hospital. They publicize that they apologize so when a patient doesn%u2019t receive an apology they will think they must have been mistaken.

All propaganda, and newspapers by printed these apology stories are helping to spread it.

WHATEVER happened to being honest because it is the RIGHT thing to do? The US healthcare system is in shambles because of dishonesty. The patients pay the ultimate price.

More news stories

Less-schooled whites lose longevity, study finds

Barbara Gentry slowly shifts her heavy frame out of a chair and uses a walker to move the dozen feet to a chair not far from the pool table at the Buford Senior Center. Her hair is white and a cough sometimes interrupts her ...

How to keep your fitness goals on track

(HealthDay)—The New Year's resolutions many made to get fit have stalled by now. And one expert thinks that's because many people set their goals too high.

Low tolerance for pain? The reason may be in your genes

Researchers may have identified key genes linked to why some people have a higher tolerance for pain than others, according to a study released today that will be presented at the American Academy of Neurology's 66th Annual ...

Growing app industry has developers racing to keep up

Smartphone application developers say they are challenged by the glut of apps as well as the need to update their software to keep up with evolving phone technology, making creative pricing strategies essential to finding ...

Making graphene in your kitchen

Graphene has been touted as a wonder material—the world's thinnest substance, but super-strong. Now scientists say it is so easy to make you could produce some in your kitchen.