court ruled against the surgeon, saying his admission was not a pro-
tected apology.
Things became even more confusing in the state when its Supreme
Court reached a different conclusion, writing that an apology "is a
statement that expresses a feeling of regret for an unanticipated out-
come of the patient's medical care and may include an acknowledg-
ment that the patient's medical care fell below the standard of care."
The case highlights an important lesson: Sometimes, it's truly hard
to tell the difference between an apology and an admission of guilt.
Disclosure programs
This is not to say that hospitals, surgery centers and physicians
should never say they're sorry or admit when they're wrong. In fact, a
sincere apology can be a part of a successful risk-mitigation strategy.
We've seen larger academic medical centers and health systems go
this route when it comes to disclosing adverse events.
More and more, these facilities have found success with their apolo-
gy and disclosure programs. In these programs, trained staff members
admit up front when they've made a mistake, and they carefully
choreograph the next steps to disclose the error to patients. These
programs typically include early settlement offers for patients and
their families. These early offers may be a little less than a plaintiff
could receive if he decided to pursue the litigation in court, but it
shows the facility is admitting its role in the poor outcome and taking
some accountability for the mistake.
Researchers who studied the University of Michigan Health
Service's apology and disclosure program found that the demands for
compensation fell by about 33%, and the number of lawsuits fell by
about 66% after its program went into effect. Those numbers may
sound impressive, but they highlight the importance of training and
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