When a doctor or a hospital injures a patient, the most common response is “deny and defend.” As many studies conducted by the medical profession itself have shown, this is a terrible way to address the problem of patient injuries caused by medical mistakes. In the first place, it drives a wedge between the patient and the health care provider. Second, by denying that anyone made a mistake, “deny and defend” greatly reduces the chances that doctors and hospitals will recognize their mistakes and learn from them. Third, “deny and defend” perpetuates the feeling among health care professionals that they are the victims of frivolous lawsuits, even when their care was clearly substandard and clearly caused a patient injury. Fourth, the “deny and defend” system is costly. Large amounts of money are wasted in the litigation process, money which could better have been spent improving patient care or reducing medical expenses overall.
There is a better way. In fact there are many better ways but “deny and defend” is tried and true and keeps the money flowing to many players who benefit from its existence. “Deny and defend” certainly keeps the money flowing to those insurance companies which sell medical malpractice insurance to doctors. It certainly keeps the donations flowing to those politicians who promise doctors they will put an end to “frivolous medical malpractice suits.” It certainly keeps the fees flowing to those lawyers who defend medical malpractice claims.
Some years ago, a former medical malpractice defense lawyer developed what is now called the “Michigan model” and put it in place at the University of Michigan Health System. Under this model, all patient complaints are promptly investigated by a team of medical professionals employed by the system. The results of the investigation, regardless of whether they favor the system or the patient, are shared with the patient. If the investigation shows that a mistake was made, a reasonable settlement is offered to the patient. The program is also sometimes called “disclosure with early offer.”
It has been successful in reducing the number of suits against the health system, reducing the number of claims against the system, shortening the time from initial patient complaint to resolution, and reducing the total liability costs of the system. Proponents of the “Michigan model” also believe that it has improved morale among the providers within the system, improved relationships with patients who have made complaints, and increased safety efforts and successes within the system. In short, it has been good for the patients and good for the system and the doctors who work in it.
By this time, you are probably asking yourself why this kind of a system is not used everywhere. If you are, perhaps you missed the part of this post where I discussed all the special interests which benefit from keeping the present, inefficient, unhealthy, dangerous “deny and defend” approach in place. Until we as citizens demand a better way, we will continue to be the victims of medical malpractice and be forced to participate in a system that benefits only the few and not the many.
