What if they started by saying 'I'm Sorry'?

When someone does you wrong - whether by accident or not - what do you really want? Well, first you want them to undo it or take it back. But also you want them to say 'I'm sorry'. It may not solve the problem, it makes you feel better. And if the error was compounded by policy or procedural problems, you want to work to help change the status quo and help prevent the same from happening to others. But the apology is what really helps.

Most people are quick to apologize. However doctors have not been allowed to apologize for errors as they might be taken as admission of guilt in malpractice lawsuits. But what if they could now start with an apology? Would that help? It would for me. If someone does something wrong or something happens that hurts when its not expected, a little apology helps.

When my drain was removed post surgery, I was told 'no problem, it doesn't hurt' by numerous friends, the doctor, and even the nurse who escorted us to the exam room where it was removed. Well they were all wrong. It hurt like hell to put it bluntly. It wasn't a grit your teeth experience, it was worse. My husband said both the doctor and nurse looked surprised and apologetic that it hurt that much. They couldn't say they were sorry about that or 'oops, we didn't expect that'. I would have appreciated that.

There is a new plan by a coalition of Massachusetts hospitals to offer an apology, financial settlement and a cooling off period before any malpractice lawsuit can be filed. And the additional suggestion is made that patients and their families be allowed to participate in committees to help change policy. Hmmm....

An error happens - its part of life.  But what if the doctor could start with I'm sorry without fear of it adding to a lawsuit. And what if people had a choice of financial settlement or had to wait six months before they could file a lawsuit. Maybe this would help slow down the 'ambulance chasing' lawyers who help incite the cases. Maybe this would lower malpractice insurance coverage and help stop forcing doctors out of medicine. I'm sorry if you disagree but I do agree.

Would you sue your doctor?

I don't think I would sue anyone unless I really felt they had done something wrong - like operated on the wrong body part. After I read this article I felt like I am the only one who wouldn't. These numbers amaze me 7.4% of all doctors face a lawsuit EACH year and 1.6% of all doctors face a payment EACH year. And we wonder why doctors charge so much because they have to pay so much malpractice insurance.

I have never understood the American way of suing people. I have a friend who told me she wanted to sue her neighbor because they had cut down the trees on their property that were shading her property or something like that. She was mad that they didn't tell her first. Hello, they don't have to tell you what they want to do on their property. They could to be nicer about things but they don't have to so why are you taking them to court? Someone else told me about the case where her neighbor is being sued by another neighbor for cutting the branches off the tree growing on her property and hangs over their driveway. They can do that legally. They could have asked first but they didn't have to so why are you suing?

I actually do know of someone who did sue their doctor. When their child was born one of the doctors failed to properly monitor the child's breathing and didn't act when needed to prevent harm to the child. As a result the child will spend its life in a special needs nursing home and has a life expectancy of less than 20 years. The results of the lawsuit pay for care needed for the child. I can see this as a case where suing was the right way.

Doctors are practicing medicine and the human body contains a lot of mysteries. Tests do not necessarily expose everything that is found when surgery begins. I had a bad day of skiing ten years or so ago. An MRI showed a meniscus tear and a suspicious ACL. Surprise, surprise, in surgery they found that I actually had a second older meniscus tear that had healed itself and my ACL was partially torn.

Yes sometimes accidents, stupidity, drug reactions, and all sorts of other blips happen in life. But they have so many double checks now that cases of operating on the wrong thing are not as common as they were. And medicine is not exact. Everyone is a little bit different. Sometimes scars heal weird, or a secondary infection happens or a medication doesn't work. Its not perfect so you can't expect perfection. You can expect a certain level of improved health but that isn't always guaranteed either.

The hope now is to move to what they call apology law where doctors and patients can hash things out with attorneys and a third attorney for a mediator to keep things out of court but get away from the emotions of a doctor's office. I am all for anything which happens out of a court room.

Malpractice Lawsuits

I have often wondered why some people are so quick to sue. There seem to be some who think the best resolution to a problem is to sue the person who bothers them - the neighbor who chopped down a tree that shaded their yard, the owner of the barking dog, etc. You get the point. They think someone did them wrong so therefore they must get even by filing a law suit.

Then there is the issue of medical malpractice. Doctors aren't perfect and medical science is not perfect either. Sometimes things don't come out right. Maybe there is an error during the procedure - if they amputated the wrong leg, took out the wrong organ, or operated in the wrong place - those are real problems and probably deserve some kind of compensation. But then there are the expectations of the patient and the end results. When I had gall stones I would get pain in the top of my left shoulder after eating rich food - after surgery I still get the pain but not as badly and it may never go away. Or after breast cancer surgery, I have shoulder pain which may never go away.

But when should you sue. If you ask me, almost never. But this article gives an idea of when you should or shouldn't.

1. If you recover from the procedure, your case probably won't be heard.

2. If you have a complicated medical history that complicates the procedure, you probably don't have a case.

3. If you receive standard care - it doesn't matter if the doctor had the bedside manner of a slug.

4. If your outcome was within acceptable risk - remember that disclaimer you signed? All surgery has its risks and you will probably always end up with a scar after.

5. If there are other ways to address the problem - meet with the doctor to get your answers, don't sue them.

And most malpractice cases are rejected. To all you lawsuit happy people out there, if you do sue and lose you could still have to pay the defendants legal bills - so you might be wise to think before you call your lawyer.

When business interests come first

If you have wondered about why drugs cost so much? Here's an example where a pregnancy drug is going from $10 per dose to $1500 per dose.

It is a form of progesterone that has been available through compounding pharmacies for decades but now the FDA has approved a branded version which will be for sale for $1500 for each dose. The owners of the branded version will make lots of money. Compounding pharmacies will face lawsuits if they continue to offer nonbranded versions of the same formula. Doctors will be forced to prescribe the branded version because it has been tested and proven.

I don't blame the FDA here. Some one wanted to offer a branded version and jumped through the FDA's hoops to get the approval. I don't blame the doctors here either. If you were practicing and concerned about potential malpractice suits by telling patients to get an untested drug when there is a tested version out there, which would you prescribe to your patients?

I don't blame the insurance companies here either or the pharmaceutical companies. I blame the system that allows the business interests to come ahead of those of the patients. If something has been made available for years cheaply, why can some one brand it and offer it for such a high price? On the other hand, why can't they brand it either? I mean if they have a special compound and want to protect it, why not? Then there is the issue of lawsuit ready patients who are ready to sue at the drop of a hat.

But why does the system allow business interests to come ahead of the interests and health of patients and controlling costs? We are capitalists but shouldn't health come before wealth?

That's not how I want to be treated

So why did your doctor order those tests? Because you should have them to find out what is wrong with you? What if you found out you endured the latest fun little medical procedure because your doctor was concerned about a malpractice lawsuit? Well, gee, thanks for the assumption that I am ready to sue you and for making me undergo another medical adventure?

Okay, so apparently this is a bigger concern for ER doctors but the point is valid. I want to only have the medical procedures that I need. Believe me, the last thing I need are any more medical adventures due to fears of malpractice. My body is forcing me to have enough medical adventures on its own.

Yes we do live in a litigious (now that's a big word early in the day) society where too many are quick to hop on the lawsuit bus because they don't like something. I know someone who is always ready to sue - their neighbors because they took down some trees, etc. You get the picture. What is the point of this? Besides creating enemies in the people you sue and making a bunch of lawyers rich? There is no point. I know lawyers who think these lawsuits are just as stupid.

I am not saying that sometimes a lawsuit is necessary and medical mistakes don't happy. Doctors and nurses are people too. And who said 'to err is human'? So what if you went for kidney surgery and they took out the wrong one, changing your life forever? Its not something that can be undone. Maybe you can't work again and will be facing huge medical bills the rest of your life. Would a lawsuit allow you some financial award so that you can have some quality of life? Perhaps.

Doctors also have malpractice insurance so its not that they are paying you out of their pockets. Unfortunately it is my understanding that malpractice premiums are incredibly high and force some doctors to alter their practice or stop practicing all together. Too many times, a patient or their family decides they didn't like the results of the doctor's treatment and then sue.

Excuse me but there are no guarantees in medicine. The human body is not a machine, each one is unique and reacts differently to treatments. They treat you as best they can and hope for the best outcome possible. A good doctor will tell you about side effects and risks to any procedure and take the time to answer your questions about options. Ask questions and understand the risks. And then don't blame the doctor if you experience the 1% risk.

I think this is another area that needs to be addressed in health care reform. If we are reforming the system in the US and one of the goals is to provide access to medical care and making it more affordable, we should not be forcing doctors out of the profession or force them to carry crippling malpractice insurance.

Today I am off to work again. I am spoiled with my schedule. This week, horror of all horrors, I have to work two days in a row. All day. Tomorrow I will 'work' from home again. There is no sign of my missing cards. I hoped that because I ordered a new Amex card, I would immediately find both of the missing ones. No such luck. I'll go get a new debit card today.