June 5, 2011

Collaborative Healthcare Solutions, an alternative to medical malpractice lawsuits

Very little is more contentious in medicine than the topic of medical malpractice, lawsuits, and tort reform. The large number of stakeholders with financial and emotional capital are immense. There is little need for me to further describe our current state of ‘deny and defend’, with fear of malpractice cases by healthcare workers, limited to no discussion after a bad outcome, defensive medicine, and assertions by plaintiff’s attorneys that they alone represent the interests of an injured patient.

Until now, when all the rhetoric and verbiage can be called to the carpet, and real justice and communication and responsibility and learning and growth and apology and forgiveness and justice can come among us. Sound too good to be true? Well, it is good, and it is true, and it is here now (not just pie in the sky), but it is not everywhere. Thanks to a few hard working pioneers, it will be in North Carolina soon. It all comes under the umbrella of collaborative law.

So, a patient is under medical care and a poor result happens. With total transparency, the ‘poor result’ is investigated and a determination is made if the standard of care was met. If care fell below the standard, then all parties are brought to the table, records and relevant data are open, apologies are made, discussions are held concerning injury and further care, and a settlement is reached. Just like that. Perhaps not in one meeting, and perhaps not at all, but that is the goal.

Now this is the simplistic description, as many meetings and discussions and proposals may be involved. If the patient is still not happy, then the traditional tort reform system can be entered.

But the beauty of this approach is that real communication occurs, the patient is heard, physicians can explain their actions and if appropriate, apologize, and healing can begin. Healing for the patient, and healing for the doctor. Bad outcomes, as catastrophic for the patient as they can be, also take their toll for the medical professional in the form of stress, doubts, sorrow, remorse, and guilt. Collaborative solutions allow the doctor and the patient to heal.

If care was appropriate and there was no error, then this is disclosed and empathy about the patient’s condition is still expressed. If there is still no resolution and a case is brought, then the case is vigorously defended.

The alternative, the current standard, requires us physicians to build a wall between us and the patient, to deny, to withhold; in other words, to stop caring for the patient. To start caring more about us than about them. And nothing could be farther from our duties and ethics and responsibilities as medical professionals than to put up barriers and restraints and just outward remove ourselves from the responsibility of caring for our patients, even those who are angry and hurt and threatening legal retribution.

Collaborative law provides a solution for this all.

Collaborative solutions allows everyone to heal, allows everyone to benefit, and allows everyone to benefit. The lessons learned from these ‘cases’ are disseminated to the entire medical community for educational purposes so that we all are aware of what and how to avoid such a mishap in the future.

And data, good data, from the University of Michigan over the last ten years, shows that this approach lowers the number of claims and amount of payouts significantly.

Collaborative healthcare solutions is coming to Raleigh, coming to North Carolina. Pilot program grants are being written, groundwork is being laid.

Can’t wait.

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