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2010-12-06

Wednesday, July 23, 2014

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The upside of honesty: Experts say 'U' error policy shown to drop claims costs

By Brienne Prusak, Daily Staff Reporter
Published December 5, 2010

Instead of keeping quiet, University doctors are encouraged to inform patients of medical errors thanks to a University of Michigan Health System program that will soon celebrate its tenth anniversary.

The program, which encourages all hospital employees to proactively look for medical mistakes, began in 2001 because of the work of Richard Boothman, the chief risk officer of UMHS.

After looking though years of medical files and concluding that honesty is vital to the future of medicine, Boothman said he realized the University Hospital would be a perfect place to start a program.

“I didn’t bring ethics to this place. It was always a highly ethical place,” said Boothman, referring to UMHS.

The goals of the program are to keep patients safe and help doctors address errors instead of firing them immediately for their mistakes, Boothman said.

Boothman added that doctors have “embraced” the initiative because the point of their job is to help others.

“I think we tapped something that is natural for them,” he said.

Peter Davis, a professional liability lawyer in Ann Arbor who is familiar with Boothman’s program, said the system allows “doctors to feel some level of comfort they haven’t felt before” when disclosing their mistakes.

Another benefit of the program according to Boothman is that it encourages doctors to be honest with patients, something both parties value.

“I think as a culture as we get courser and the political discourse gets more and more polarized, the idea that people can actually be sincere and honest becomes more and more a foreign concept,” he said. “I think that’s a big reason why there’s such a preoccupation with our program.”

In 2003, Dr. Allen Kachalia, the chief medical resident at the time, received a grant from Blue Cross Blue Shield to study the program’s effects, specifically if the number of liability claims filed changes when a hospital decides to disclose medical errors.

Kachalia explained that the results of the study showed that a better informed patient, and one who is treated as an individual, is a lot less likely to respond in an adversarial way to mistakes, which will in turn reduce claims.

Kachalia said the University Hospital was one of the first public medical centers to use a program that encourages doctors to disclose their mistakes.

Davis, the liability lawyer, said the program set a precedent for handling medical malpractice cases and laid the groundwork for other hospitals to push similar initiatives.

“It is a program that serves the public,” he added.

Though other institutions can learn from the program at UMHS, Kachalia emphasized that UMHS’s program is just one institution’s experience and doesn’t conclusively prove that medical disclosure lowers liability. Instead, it shows that one center has been successful in lowering claims costs.

Between 2001 and 2007, the number of average legal expenses for UMHS declined 61 percent, according to the medical journal “Annals of Internal Medicine.”

Boothman and Kachalia say patients have responded favorably to the program.

“Most patients would appreciate any medical system that is going to be transparent, admits its mistakes and offers compensation for its mistakes,” Kachalia said.

There is also now a greater emphasis on the quality of the relationship between the doctor and patient, he continued.

Dr. Lakshmi Halasyamani, vice president of quality and systems improvement at St. Joseph Mercy Hospital, said admitting medical errors is not only important for decreasing claims costs, but it’s also “the right thing to do.”

According to Halasyamani, St. Joseph Mercy Hospital implemented a program five years ago that is similar to the program in place at UMHS. St. Joseph Mercy Hospital’s program encourages doctors to admit mistakes and guarantees that they are supported throughout the process.

“(UMHS) is not the only one who has made these changes,” Halasymani said. “They’ve just had an opportunity to evaluate their changes.”

Boothman said the hospital is always working to improve medical practices and added that employees don’t plan to return to their former practice of suppressing mistakes.


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