As a 19-year employee of Physicians Insurance, I have been involved in shaping HealthPact’s Disclosure and Resolution Program. Physicians Insurance enthusiastically embraces the efforts of HealthPact because it represents our longstanding commitment to the delivery of safe health care. It is that pledge by the organization and by our individual physician members that has made my tenure a proud association.
Doctors are drawn to medicine because they want to heal, not harm. When an adverse outcome occurs, everyone is impacted—the patient, the clinician, the health care team, and the organization. As individuals and as representatives of our respective professional interests, I suggest we view this as an opportunity and obligation to look for common ground and to consider the most humane way to respond when errors occur. PI has practiced this philosophy, but never with the benefit of collaborating with so many HealthPact members.
Briefly, I’ll share the experience of one of our insured providers, an anesthesiologist. He was present in the hospital at the end of a long day—not on call or backup call—but attending to a few administrative matters before heading home. He received a call from his partner in an OR, who said a patient might be in trouble; could he check her out? The anesthesiologist said, “Of course,” and ran upstairs to see the patient. He had never met this patient and had no information about her. The postop patient had bled into her neck and was rapidly losing her airway. The doctor quickly assumed responsibility for her care, and with the help of several other emergency responders, established an airway, thereby saving her life. Still, the patient sustained a significant brain injury. The anesthesiologist was sued, and after a lengthy and costly period of litigation, defended at trial.
During that process the doctor questioned whether he should have moved faster than humanly possible, should have known what he could not have known, or done what he was not trained to do. He never stopped regretting the injury to his patient. The trial took a significant toll on the parties, especially the patient’s family. A verdict was returned for the doctor. There was no celebration. The doctor and his colleagues continued to worry about the patient, as did one of the defense attorneys, Liz Leedom, and Physicians Insurance. After the verdict, we retained a case manager to assist the patient with her long-term care. It was a small but meaningful gesture. I have wondered if something could have been done to save the patient from medical harm and to save the parties from the harm of litigation. Perhaps a process like the DRP could have been helpful.
I will leave you with a quote borrowed from Atul Gawande: “The important question isn’t how to keep bad physicians from harming a patient; it is how to keep good physicians from harming patients. Medical malpractice suits are a remarkably ineffective remedy.”
We all know Dr. Gawande’s statement to be true. There is nothing about a lawsuit that will keep the next patient and the next health care provider safe from harm.