The simple fact is that bad things do happen to good people and adverse medical events will occur. Questions that must be addressed include what steps should be taken by the medical provider and what does the patient expect from the medical provider.
The jaded view might be that patients want compensation, so best to turn it over to the insurance company to handle. That statement is only half-right. Whenever an adverse event occurs, immediately contact your insurance provider for guidance and direction. As for compensation, patient expectations are not always that simple.
According to the Canadian Medical Protective Association in responding to data presented in a New Zealand study, the Canadian medical liability system provides responses in three areas: patient safety, professional accountability, and litigation.
An article in the Journal of Healthcare Risk Management parallels the Canadian approach by indicating patient expectations centering on acknowledgement of the event, an apology, complete details about the incident, assurance that corrective measures have been taken, and compensation.
These, along with other expert opinions and studies, seem to indicate that litigation and compensation are not necessarily at the top of the patient expectations list when it comes to an adverse medical event. Yet many providers consider that to be at the top of their list and that can affect the attitude towards the patient. The reality is that the manner in which a healthcare provider manages communications after an adverse event can determine the subsequent actions taken by the patient, including formal complaints and litigation.
The initial reaction of most patients deals with the inquisitive side of human nature. They want acknowledgement of the incident and the complete facts as understood by the medical provider. This is an area where patient and provider can work together in sharing of information about the event in order to better understand contributing factors and the taking of subsequent preventive actions to protect future patients. Remember that acknowledgement of an event should also include empathy with the emotional feelings of the patient and family.
When it comes to an apology, there are differing schools of thought. Some say that an apology will come back to haunt you in litigation; others say that an apology can help defuse a litigatory event. This is why it is critical to immediately contact your insurance provider for guidance when an adverse event occurs. However, research has shown that apologies without remorse are likely to be rejected, and that some patients will not be forgiving — even after an acceptable apology with remorse is given.
An adverse event can often trigger an altruistic response on the part of the patient. They want to proactively help prevent future mishaps impacting the lives and health of others.
We occasionally see this in situations involving celebrities. Their efforts are focused on prevention and patient safety, as opposed to monetary compensation.
A second and important expectation is that the medical professional accept responsibility and be held accountable. Again this goes back to human nature. An “I’m sorry” apology seldom holds as much weight as one that accepts responsibility, shows a willingness to be held accountable, and a firm desire to avoid reoccurrences.
The final expectation is compensation. This can be based on the personal financial needs of the patient (seizing an opportunity) or can actually be the result of the response of the medical provider and community to the event.
For instance, consider a patient with an adverse event. Concern is expressed, information shared, and corrective actions taken. The patient seems satisfied at that point. Then, shortly after returning home, the hospital and doctor bills begin arriving. The patient feels that everyone is after money for a procedure that went awry and required additional treatment for correction. At that point, some patients will arch their back and call their attorney to file suit. They feel that the acceptance of responsibility was merely a verbal response with a financial loophole. That is why some medical centers take firm steps to ensure that a patient has no out-of-pocket expenses related to an adverse medical event.
Likewise if an investigation is conducted about an adverse event, keep the patient in the loop. They want to know that demonstrable actions have been taken to ensure that others will not suffer the same fate. If you do not provide information on the results of the review and actions taken, they will feel that their experience has been for naught and may take further actions to take it public.
All that being said, the one factor that will result in a lawsuit faster than anything else is the appearance of a “cover up” by what is perceived to be the “medical establishment”.