May 20, 2008
In 40 years as a highly regarded cancer surgeon, Dr. Tapas K. Das Gupta had never made a mistake like this. When an electrode was left inside Maria Del Rosario Valdez after her son was delivered by Caesarean section, she was gratified that the hospital quickly acknowledged its mistake and corrected it without charge. As with any doctor, there had been occasional errors in diagnosis or judgment. But never, he said, had he opened up a patient and removed the wrong sliver of tissue, in this case a segment of the eighth rib instead of the ninth.
Instead of hiring a lawyer, the doctor in question did something unimaginable.
After all these years, I cannot give you any excuse whatsoever,” Dr. Das Gupta, now 76, said he told the woman and her husband. “It is just one of those things that occurred. I have to some extent harmed you.
Sunday’s New York Times carries the story of what’s happening in some US hospitals when doctors admit to being human, to making mistakes and what happens when those mistakes are followed up with an apology.
In Dr. Das Gupta’s case in 2006, the patient retained a lawyer but decided not to sue, and, after a brief negotiation, accepted $74,000 from the hospital, said her lawyer, David J. Pritchard.
and from the hospital’s perspective
“Improving patient safety and patient communication is more likely to cure the malpractice crisis than defensiveness and denial,” Mr. Boothman said.
Mr. Boothman emphasized that he could not know whether the decline was due to disclosure or safer medicine, or both. But the hospital’s legal defense costs and the money it must set aside to pay claims have each been cut by two-thirds, he said. The time taken to dispose of cases has been halved.
The number of malpractice filings against the University of Illinois has dropped by half since it started its program just over two years ago, said Dr. Timothy B. McDonald, the hospital’s chief safety and risk officer. In the 37 cases where the hospital acknowledged a preventable error and apologized, only one patient has filed suit. Only six settlements have exceeded the hospital’s medical and related expenses.
Can you imagine? The professions admitting to their humanity? to being imperfect and infallible? It seems like such a long way from where we are in this country where at the first sign of imperfection we call the spin doctors, legal profession and attempt to maintain the facade of the idealised system that can in no way let us down. I’d prefer the disappointment – or in other words, the reality rather than the fantasy. But I wonder how comfortable any of us are admitting to not having answers? to making mistakes and to managing the anxiety of wondering if our clients could accept us if we presented as our imperfect selves?
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Annette, here in NH they actually legislated apology! That is, they made it possible to do what Dr. Das Gupta did without undue liability risk. Part of me felt good about the doors it opened for honest conversation between doctor and patient, and part of me felt very sad that we’re so litigation-minded a culture that we have to protect apology before it can be offered in situations like these.
I sometimes tell my workshop attendees that we’re all imperfect humans trying to live our lives with a little grace, and your closing question brought me back to that again. I think we’ve damaged ourselves in the quest to prove our perfection.
That’s so interesting Tammy and I agree with you that it’s sad on one level that apology has to be protected in this way…but I also wondered if the quality of the apology – its humanity – has been in any way institutionalised by formalising it? Or whether the formalisation is seen as something useful and helpful?
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