Wednesday, April 8, 2009

Physicians and Attorneys In Service Together

I'm frustrated, having just read another article (NY Times, Just Medicine, April 2, 2009) in which physicians are portrayed as victims of attorneys. We're told that physicians conceal errors, don't offer explanations or apologize, don't communicate with their patients, and practice "defensive medicine", all because they fear and blame attorneys. Let's take this opportunity to stop blaming and finger-pointing, which divides and erects walls between us. Why don't we attempt to define blaming out of bounds?

When physicians and attorneys begin to set aside blame in our conversations, we can more effectively work together, communicate clearly, build trust, set aside misconceptions, and create a common vision in the arena of responding to adverse medical events. How do we bring all the stakeholders (physicians, attorneys, insurers and others) into the conversation, such that they can discuss new ideas and new evidence, leading all of us to a healthier, more healing place in the adverse medical event context?

One effective process is dialogue, a collaborative process that promotes communciation across misconceptions, misunderstanding and differences through listening, thinking and talking together to find creative options that allow all stakeholders and interested parties to build community, build common understanding and work together. Rather than: it's the lawyers who want to line their pockets, it's the insurance companies who never want to pay any claims, the conversation becomes: how do we move forward to our common goals, patient safety and explanation to the injured party? Are there creative alliances that can accelerate this process, the process of bringing transparency, fairness and healing to all parties, a process that protects the public, reduces medical errors and promotes the highest levels of patient safety? These are questions for powerful, creative dialogue.

Dialogue can take place at any time but is most effective before adverse medical events, before attorneys and physicians become adversaries. It gives us the opportunity to discuss fairness and healing and to examine our common humanity and values, one of which is healing. Former Chief Justice of the United States, Warren Burger, said, "The healing function ought to be the primary role of the lawyers in the highest conception of our profession..." Similarly, the AMA Declaration of Professional Responsibility: Medicine's Social Contract With Humanity, states that physicians "commit themselves to advocate for social, economic, educational and political changes that ameliorate suffering and contribute to human well-being." Thee mission of both professions is, to a great extent, healing.