Wednesday, February 16, 2011

President's Budget

Included in the President's Budget proposal is a call for a "more aggressive effort to reform our medical malpractice system to reduce defensive medicine, promote patient safety, and improve patient outcomes." The President called for $250M in Justice Department grants to help states rewrite their malpractice laws. The good news is these grants will provide the opportunity to address these issues in the legislatures of all the states, through hearings, public comment, and analysis of what has worked in the past and what new nonadversarial practices will give patients a voice in the outcome.

One of the ideas suggested is health courts. I think health courts are as antithetical to healing as traditional litigation. Neither give the patient a voice in the process. Neither promote patient safety, as they are based on secrecy and long delays, missing the opportunity to take the patient's experience forward expeditiously to create improved healthcare. Collaborative law/practices, on the other hand, create the opportunity for expeditious resolution, chosen by and agreed to by the parties, enhanced patient safety, acceptance of responsibility for error, and healing fo all parties, physician and patient alike.

Requiring physicians and hospitals to disclose early, offer apology and compensation is another approach suggested by the Administration. However, that approach has been required by law for some time in several states, including Pennsylvania, where it has been found to be generally ineffective. Can these ethical obligations be legislated? Should they be legislated? Voluntary diclosure programs, such as the one that has existed for ten years at the University of Michigan Medical Center, have been shown to be very effective, lessening litgation to a great extent and lessening payouts associated with errors.

Perhaps the use of colaborative law/practices in medical error situations can be validated and supported through the legislative process. That is my hope.

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