You continue to face exposure if you apologize

Key Points

Two recent studies have refocused attention on the question of whether apologizing for medical errors can reduce the cost of malpractice.

The study found that after full implementation of the program, the average monthly rate of new claims decreased significantly, as did the average monthly cost rates for total liability, patient compensation, and noncompensation-related legal costs.

MICHIGAN EXPERIENCE RATHER UNIQUE

The University of Michigan study, despite its encouraging raw data, notes that during the latter part of the study period, malpractice claims generally declined throughout the state. The study fails to compare the statewide rate of decline with the rate of decline experienced within the health system, however. Of course, if the rate of decline mirrors or exceeds that experienced by the University of Michigan Health System, then the conclusions to be drawn from the study would be the opposite of those suggested.

Moreover, the Michigan experience is rather unique and may have little or no application in most other settings. The health system has a closed staff model, and insurance is provided to the entire staff, as well as to the hospital, through a captive insurance company. As such, when a payment is made in settlement of a case, reports to the National Practitioner Data Bank are circumvented by having the settlement made in the institution's name rather than in the name of the individual caregiver(s) who may have been at fault. As such, a primary concern-that admitting to an error could result not only in payment of a malpractice claim but also in loss of medical license, hospital privileges, and managed care contracts-does not exist within the Michigan system. Nor is there the risk of losing insurance coverage if the admission is made without the prior approval of a malpractice insurer.