The current session of the General Assembly will consider a new version of “apology legislation” that permits physicians and health care systems to explain medical errors, offer sympathy and seek opportunities to improve care without the fear of legal retribution.
For example, I recently saw a patient who had a complication from abdominal aorta aneurysm surgery that has left him a paraplegic. The medical record is unclear on the nature of the complication or the medical and/or system error that led to this tragic result. The patient expressed his reticence to file suit, but over several months of communication with the doctors and the hospital system, he was unable to understand the exact circumstances of the event and felt as though he had no choice, if for no other reason than to receive an explanation.
During a doctor-patient relationship medical errors may occur in a labyrinth of diagnostic and treatment decisions. There are errors of missed or delayed diagnosis and/or treatment and system errors, all by well-meaning physicians and health systems. The Institute of Medicine estimates that 98,000 deaths occur each year due to medical errors. The IOM has also found that 90 percent of these deaths are the result of failed systems and procedures and not physician negligence.
Studies show that patients file suit not to place blame but due to a lack of communication, empathy and full disclosure by physicians or systems of care. Often, a patient’s only recourse may be to use the judicial system to seek the above explanation.
This legislation is about the doctor/patient relationship. It is about trust and empathy at a critical time for the patient and/or family. The legislation is about changing the construct from one of blame and secrecy to one of cooperation, communication and improvement in the quality and safety of health care. This legislation permits physicians and health care systems to offer full disclosure without the fear of legal retribution, while not abrogating the rights of any patient.
Patients and families still have a right to proceed with the legal process without compromise and seek just compensation for their injuries. The legislation may also decrease health care costs by decreasing the volume of claims that currently lead to long and arduous legal proceedings that only delay compensation for justified claims. This legislation will contribute to better patient care, an improved doctor/patient relationship and decrease costs. Rhode Island residents need to support H-7290 and the companion Senate version as they move through the General Assembly. •
Dr. Nitin S. Damle is a practicing internal-medicine specialist in South Kingstown, president of the Rhode Island Medical Society and a member of the Board of Regents of the American College of Physicians.