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Practice of Hospital Apologies Is Gaining Ground


From NPR News, this is ALL THINGS CONSIDERED. I'm Andrea Seabrook.

When a doctor makes a mistake - misses a diagnosis, say, or prescribes the wrong medicine - the results can be disastrous. Up until recently, doctors who wanted to apologize couldn't. They were told an apology could be taken as an admission of guilt. If the mistake becomes a subject of a lawsuit, the apology can have a big influence on judge and jury.


But that whole scenario has begun to change in recent years. And the practice of openly apologizing when a medical error errors is gaining ground across the country, and it's helping doctors and hospitals avoid costly lawsuits.

Rachel Gotbaum has our report.

RACHEL GOTBAUM: Four years ago, Jennifer Wagner(ph) felt a lump in her right breast so she went to the doctor, an internist at the University of Michigan Health System. He told her that the lump was just fibrous tissue and that she should get a mammogram when she turned 40.

JENNIFER WAGNER: He just sent me home and said, you know, there's nothing to worry about. So my husband and I cracked open the champagne and said everything's good.

GOTBAUM: Wagner was 34 at the time, a mother of two small children. As the months went by though she realized her initial sense of relief was misplaced. Something was wrong.


WAGNER: It almost felt like one of my ribs was popping out or something. It was like a long hard section in the crease where my breast met my body. And so I thought that just doesn't feel right.

GOTBAUM: Over the next year, Wagner would see two other internists at the University of Michigan. They both told her the same thing - that her breast lump was just fibrous tissue and she didn't have to worry.

The third doctor decided to send Wagner for a mammogram anyway. That mammogram revealed that Wagner did indeed have breast cancer and it had already spread to other places at her body. The diagnosis had taken almost two years.

WAGNER: That 21-month delay probably shortened my life.

GOTBAUM: Wagner hired a lawyer and considered suing the University of Michigan Health System for negligence. The hospital knew its doctors had made a mistake and should have diagnosed Wagner's cancer earlier. But instead of denying the error and preparing for a long drawn out and costly legal battle, the hospital's attorney did something unusual.

RICK BOOTHMAN: One of the first things we did was call her lawyer and say I agree that this diagnosis should have been made earlier. That's not something we're going to fight about.

GOTBAUM: That's Rick Boothman, the hospital's attorney. The meeting he asked for would not only include Jennifer Wagner's attorney but also Jennifer Wagner, her husband and the two oncologists from the hospital who were treating her cancer.

The goal was to give Wagner a change to tell her story for the hospital to acknowledge the mistakes it had made and for Wagner's doctors to explain openly how the delay in her diagnosis could impact her future.

WAGNER: My husband and I both left that meeting feeling like a million bucks. I was heard that night. That's all I really wanted. I wanted them to know that this was not right - what had happened to me.

GOTBAUM: As a result of the meeting, Wagner settled quickly with the hospital. Her lawyer, Tom Blaskey(ph), says the University of Michigan's approach, disclosing the truth to patients and acknowledging a mistake, means a settlement can be reached sooner and court can be avoided. That means everyone can save money in legal costs. But the most important benefit, he says, is to his sick clients like Jennifer Wagner.

TOM BLASKEY: This is a woman who probably is going to die from her cancer. And she's probably going to die earlier than she would have if her cancer had been diagnosed on time. The consequence of that for her life is, most of all, she wants to be sure that things are put in order and that her family is provided for. She needs to not go to her grave with this thing unresolved.

GOTBAUM: The University of Michigan Health System adopted Open Disclosure, as it is known, five years ago. Attorney Rick Boothman established the program after more than two decades defending hospitals against malpractice claims - years in which he learned some valuable lessons.

BOOTHMAN: I tried a case early in my career when after winning the case and the jury was dismissed, the lady who sued my client leaned across the podium and said, if you had only told me everything that I heard in this courtroom, I would never have sued you in the first place. That really left a mark on me. And for 20 years, I wondered why we don't talk to each other.

GOTBAUM: As part of the disclosure program, the University of Michigan Health System has established a comprehensive communication network so health care providers can call or e-mail about medical errors.

The new transparency is helping to encourage staff to speak up when a mistake has been made. Dr. Darrell Campbell is a transplant surgeon and chief of staff the hospital.

DARRELL CAMPBELL: The impact is the people are willing to come forward with not only problems that have happened. But the most important thing is potential problems. So we never used to hear that before. But now, we hear about near misses and that's critical in terms of improving patient care.

GOTBAUM: Patients who are victims of medical errors are also now being videotaped so health care providers can learn from those cases. One story that is included is that of breast cancer patient Jennifer Wagner.

WAGNER: The fact that internal medicine doctors at the U of M are going to have to view a video tape of me talking about my case, I think that is going to be the best part because no telling how many how women are going to be sent for a mammogram now because of something that happened to me.

GOTBAUM: The disclosure program is also saving the University of Michigan Health System lots of money. Malpractice claims have dropped by two-thirds. And millions of dollars have been saved in legal fees and insurance costs.

Nationwide, other hospitals are beginning to realize that acknowledging medical errors may not only be a cheaper way to handle disputes with patients but could also save lives. So far, 70 percent of the country's hospitals have adopted some form of disclosure program and the number is growing.

For NPR News, I'm Rachel Gotbaum. Transcript provided by NPR, Copyright NPR.