Wednesday, November 11, 2009


I'm reading Aaron Lazare's "On Apology". One of the apologies he discussed really struck me and brought to mind what I've read about many adverse medical event situations. The story involved an 82 year old man who was the son of Holocaust victims. The man sued the French National Railroad System for its part in deporting 76,000 Jews from France to the concentration camps.
The compensation he requested: one Euro and acknowledgment by the railroad that it played an active role in the deportation. Noone could say that all he cared about was the money.

While doing research for my dissertation, I found an accumulation of evidence that many patients/families litigated medical malpractice cases to find out what happened and to protect future patients from the same mistakes. The money was secondary. Just think about what that says about our communities, our humanity. This, of course, is not to suggest that patients/families should not seek compensation, just to point out how important acknowledgment and helping others are for injured patients/families.

Wednesday, November 4, 2009

tort reform/medical malpractice liability reform

Caught part of the interview on NPR of Rahul K. Parikh, M.D., a pediatrician in my neighborhood. From there, I found his post, a post I so appreciated and generally agreed with. Dr. Parikh, both in his post and in his interview, addresses "defensive medicine" and its focus on blame. He, like so many other authors and thinkers on this topic, does not discuss how adverse medical events are handled in our health care systems BEFORE litigation, i.e. has there been disclosure, meeting with patients/families, opportunity for patients/families to offer first-hand information that could improve patient safety for future patients, apology and/or offers of compensation, if appropriate.

We hear statistics about "frivolous lawsuits". I'm not sure what that means, who is making that determination, if anyone, that a percentage of med mal cases filed are "frivolous". Are these cases that may not involve compensable injury but involve injured patients or their families who are unable to get any answers, are unable to get any health care provider to talk to them? Does that make their claims "frivolous"?

Can we START this conversation with the response of the health care providers to adverse medical events, completely aside from concepts of error and/or negligence? Why don't we try to establish criteria to determine if conversations between health care providers and patients/families after adverse medical events are improving patient safety practices for future patients? Why don't we start keeping statistics/anecdotes on how many medical malpractices cases are filed after disclosure, after conversation and open exchange, after listening to patients' experiences?

I think the way to change the conversation, expand the conversation, is one person at a time. As long as the conversation continues to blame the lawyers, we can't move forward. Like the conversation about caps on damages, the conversation about "defensive medicine" is not helping the patients. Both physicians and attorneys are healers, in my opinion, so let's get back to healing: healing the patients AND the health care providers, the "second victims". Let's start with the language of healing.

Who's with me on this?