Why Sorry Works! works
Overview of Sorry Works Program for the Medical Malpractice Crisis

Thursday, Nov. 11, 2004

What is Sorry Works?
Sorry Works! is an extreme honesty program for doctors, hospitals,
and health care providers. The program is based on the successful 17
year experience of the Lexington, Kentucky VA hospital which reduced
lawsuits, settlement costs, and defense costs.

Sorry Works says when medical mistakes or unanticipated outcomes
occur, doctors and hospitals should thoroughly review the facts of
the case and quickly notify the patient and/or families with the
findings. If an error or mistake is found, the hospital should
apologize, offer answers, and provide a fair settlement up front.
Providing a fair settlement upfront is as essential as the apology.

The hospital should ask the family to retain legal counsel to ensure
their rights are protected and preserved throughout the process.
Finally, patients and families should be allowed to participate (as
much as possible) in the effort to make sure the medical error does
not happen again.

Sorry Works - standing logic on its head? No! It works!
Logic says that Sorry Works should invite lawsuits, right? After all,
when things go wrong, people are told to keep quiet, get a lawyer,
don't have meetings which could produce notes and witnesses, and, if
necessary, lie and destroy documents.

This climate of cover up and conceal which is intended to reduce or
eliminate lawsuits actually produce lawsuits. This current climate
makes filing a lawsuit the only option for injured people, as opposed
to a lawsuit being the last recourse (as it should be). Furthermore,
this cover up climate leads to large verdicts because juries become
enraged by cover ups and seek to punish the doctors and hospitals.

Sorry Works takes us back to what we were taught in Kindergarten. If
you break someone's toy, apologize quickly and repair the damage. It
seems to stand logic on head, especially when large sums of money and
professional careers hang in the balance; however, “sorry" does
work.

The VA hospital in Lexington, KY has practiced the Sorry Works
approach for 17 years and has reduced lawsuits, settlement costs, and
defense costs. Only three cases have gone to trial over the 17 year
experience, and the average settlement is $16,000 versus the national
VA average of $98,000. Furthermore, cases are closed in 2 to 4 months
instead of the usual two to four year average, which saves on defense
costs.

The Joint Council for Accreditation of Healthcare Organization
(JCAHO) has used the Lexington experience to develop a protocol by
which all hospitals - private and public - should follow to be
accredited. Private hospitals in Boston and Minneapolis have adopted
the extreme honesty approach and others will hopefully follow soon.

How does Sorry Works! reduce lawsuits?
What generates a medical malpractice lawsuit? Answer: anger. Patients
and families become angry when they do not get answers or
accountability. Patients don't expect perfection from doctors or the
medical system, but they do demand honesty, especially when things go
wrong, and a good faith effort to make things right. But if the door
is slammed in their face, patients and families have no choice but to
call a lawyer and initiate a lawsuit.

Sorry Works removes the anger from the process, and in most cases the
need to file a lawsuit. By offering an apology and providing a fair
settlement upfront, patients and families are treated in a
compassionate manner. Instead of being treated like the enemy,
patients are elevated to a special status where the hospital tries to
make amends for the error or bad outcome. When patients and families
are treated with good will, the feelings are usually reciprocated.

Sorry Works! also reduces "frivolous" filings
It's a fact: Many lawsuits against doctors are dropped or dismissed.
Critics of the court system claim dismissed lawsuits are "frivolous"
and these frivolous filings drive up insurance premiums. These
"frivolous" filings should be eliminated, and Sorry Works! provides
the solution.

When a medical error occurs today the only people who talk are the
patients and families. The hospitals and doctors circle the wagon and
clam up. The lawyer has no choice but to name everyone in the lawsuit
and then dismiss people through the discovery process.

With Sorry Works the hospital and doctors are transparent. Honesty
rules the day, and there is no question about who is involved with
the case.

Finally, with Sorry Works, hospitals gain a reputation of honesty
with local trial lawyers. If a "Sorry Works" hospital decides they
will fight a case (i.e, not apologize and settle), then that is a
strong signal to the trial bar that the case is probably without
merit and not worth pursuing.

Sorry Works! wins in court too!
There are two components to medical malpractice lawsuits: the merits
of the case (did an error occur?) and the financial considerations
(if an error occurred, how much compensation is due to the injured
party?).

When errors are discovered and revealed with Sorry Works, these
errors are disclosed immediately with an apology along with all
related documents and files. With the merits of the case decided,
Sorry Works! says the hospital should make a good-faith effort to
provide a fair settlement quickly to the injured party. The hospital
and the injured party's attorney discuss and hopefully agree on a
fair settlement.

But what happens if a settlement is not reached? Then a lawsuit will
follow, but the case will only focus on the financial considerations
(the merit of the case has already been decided). On one side you
will have the doctor who has admitted fault and tried to do the right
thing by offering a fair settlement, and on the other side you will
have the plaintiff who will look greedy for not taking the settlement
offer. The odds are in favor of the doctor in this scenario, and this
why only three lawsuits went to trial against the Lexington VA
hospital in their 17 year experience.

Sorry Works! improves healthcare and reduces repeat medical errors
The current "cover up" climate dooms doctors to repeat the same
medical mistakes again. Why? Because doctors are encouraged NOT to
talk and have meetings which could produce notes and witnesses.
Defense lawyers tell everyone to be quiet. Therefore, medical
mistakes don't receive the thorough review needed to prevent them
from happening again.

Under Sorry Works, doctors talk freely and discuss what happened and
how to prevent it from happening again. Furthermore, patients can
become involved and contribute to the learning process. Sorry Works
encourages discussion and review, which leads to improvements in the
healthcare system.

Sorry Works! also preserves the doctor-patient relationship
The quality of the doctor-patient relationship is essential to
continuous quality health care. Unfortunately, under the current
system, doctors and patients become enemies when mistakes happen.
They only speak through their lawyers. The relationship is severed,
often permanently.

With Sorry Works, doctors and patients continue to talk and work
together to learn from the medical error and improve healthcare. At
the VA in Lexington, several patients and families continued to use
the same doctor even after an error because they appreciated the
honesty and forthright approach.

But would trial lawyers live with Sorry Works?
Yes! With the current "cover up" climate, trial lawyers must invest
$20,000 to $50,000 dollars per case and carry the expenses two to
four years before the case is typically settled or disposed.
Furthermore, only one in three medical malpractice cases has a
successful outcome for the plaintiffs.

Under Sorry Works, the plaintiffs' attorney represent the patient or
family, negotiate a fair settlement, and dispose of the case in two
to four months with very little upfront expenses.

Can Sorry Works! work in the private sector?
Yes. Sorry can work in the private sector, but it is more challenging
since multiple, independent parties (insurers, lawyers, etc) have to
brought to the table and agree upon the approach. However, once all
parties agree to Sorry Works, the parameters should be the same.
Patients in the VA system wish to be treated the same way as patients
in private hospitals - with honesty.

What is the Sorry Works! pilot program?

The Sorry Works pilot program will "hold harmless" six Illinois
hospitals that try Sorry Works for a two-trial period. This is
basically a "no risk" try for the hospitals. Below is the outline and
specifics of how the program will operate:

Establish a working committee to develop, oversee, and implement the
Sorry Works! pilot program. Members of the committee shall include,
but are not limited to, appointees from the following
organizations/groups:

1.)     Illinois Department of Insurance
2.)     Illinois Department of Professional Regulation
3.)     Illinois State Medical Society
4.)     ISMIE Mutual Insurance Company
5.)     Illinois Trial Lawyers Association
6.)     Illinois Hospital Association
7.)     Two physicians designated by the State Medical Society
8.)     Two trial lawyers designed by the IL Trial Lawyers Assoc.
9.)     Two hospital administrators designed by the Illinois Hospital
Association
10.)    Two actuarial experts agreed upon by ISMIE, Illinois State
Medical Society, and Illinois   Trial Lawyers Association

Staff from the Governor's office and General Assembly will be allowed
to attend, monitor, and participate in committee meetings.

The committee will be responsible for establishing the exact criteria
of the pilot program, including eligibility for hospitals, doctors,
and insurers to participate in the program, establish criteria for
the method by which hospitals, doctors and insurers will be held
harmless under the program, establish a sub-committee to review cases
from hospitals and determine if hospitals, doctors, and insurers are
due compensation under program.

The committee will dialogue with hospitals, doctors, and insurers who
are interested in participating in the program and ultimately decide
which applicants will be accepted for the program.

The committee will report to the Governor and the General Assembly
every six months

At the end of the two-year trial period, the committee will publish
data from the program.

Normal and reasonable costs of committee members in conducting their
assigned duties will be reimbursed

Overview of program:

The program would be open to six hospitals for two years.

Hospitals, doctors and insurers participating in the program would be
"held harmless" by the State of Illinois for excessive liability
incurred during the Sorry Works! two year trial period. It is the job
of the Sorry Works committee to develop standards and protocol to
compare settlements and defense costs for cases handled with
traditional means versus cases handled under the Sorry Works!
protocol. If in the opinion of the committee, a case results in
excessive settlement costs because of the Sorry Works protocol, then
the State would pay for the difference in settlement cost between
what is generally considered a fair settlement versus what was paid
under Sorry Works.

Final point:
If in the opinion of the committee, the program in resulting in
excessive settlement costs, the program can be terminated by a 2/3
vote of the committee members and agreement by the Governor.

SOURCE: Victims and Families
http://www.victimsandfamilies.com/Sorry.phtml

* * *Murray Charters <[log in to unmask]>
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