Admit small errors, pay for larger ones
Two recent studies provide answers to two frequently asked questions in health care risk management: What can I do to keep a patient from suing? What is the likelihood I will have to pay on a malpractice claim?
For the first question, the answer appears to be that patients want doctors to admit their mistakes, even minor ones.1 A team of health care providers in California conducted a survey of patients and asked them to explain how they would prefer their doctor react after committing minor, moderate, and severe errors.
Virtually all of the patients, 98%, desired some acknowledgment of even minor errors, such as a prescription error with no adverse outcome. Fourteen percent wanted to be referred to another physician after a minor mistake and 65% after a severe mistake, such as missing a cancer diagnosis.
With both moderate and severe mistakes, patients were significantly more likely to consider litigation if the physician did not admit the error. After moderate mistakes, 12% of patients said they would be likely to sue if informed of the error, but 20% said they would be inclined to sue if not informed. After severe mistakes, 60% would sue if informed and 76% if not informed.
In the second study, researchers found that the severity of the patient’s disability determined the likelihood that a plaintiff would be paid in a malpractice case.2 They studied 51 malpractice suits and followed them over 10 years to determine if payment was made. Forty-six of the cases were closed. Of 24 that the researchers determined had involved no adverse event, 10 were settled with an average payment of $28,760. Of 13 that involved adverse events but no negligence, six were settled with an average payment of $98,192.
Nine cases included adverse events due to negligence. Five of those cases were settled with an average payment of $66,944. Of eight claims involving permanent disability, seven were settled with an average payment of $201,250.
A detailed analysis of the claims suggests that the extent of the plaintiff’s disability, far more than any other factor including actual liability, determines the likelihood that a plaintiff will receive payment.
References
1. Witman AB, Park DM, Hardin SB. How do patients want physicians to handle mistakes? Arch Intern Med 1996; 156:2,565-2,569.
2. Brennan TA, Sox CM, Burstin HR. Relation between negligent adverse events and the outcomes of medical- malpractice litigation. NEJM 1996; 335:1,963-1,967.
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