Physician Disclosure and Resolution Programs Pose Problems, Study Shows
Programs that allow physicians to disclose medical errors, apologize to patients and offer compensation are considered a central strategy in medical malpractice reform, but a new study published in Health Affairs has identified some caveats in the concept of compensating for medical errors.
Disclosure and resolution programs allow providers at hospitals and health systems to disclose and apologize about adverse events to affected patients and their families. When appropriate, the program also enables organizations to offer compensation to the patient and/or family.
Study authors compared the effects of different compensation offers on individuals' responses to the medical errors compared with their responses when there was an explanation and apology alone. About 3,250 respondents randomly received one of 16 vignettes that depicted either diagnostic or surgical errors, disclosure or apology and one of four compensation offers.
The four compensation offers consisted of: no compensation; waiver of medical expenses only; reimbursement for out-of-pocket expenses up to $25,000 and loss of time up to $5,000; and compensation of economic losses as well as pain and suffering, which is comparable to what is available in a malpractice lawsuit.
Researchers found two-thirds of individuals desired compensation offers, but the proportion of people who were "very likely to accept" compensation declined as the generosity of the offer grew. For example, 46 percent of people who were offered reimbursement for medical expenses were very likely to accept compared with 36 percent in the limited-reimbursement group and 25 percent in the full-compensation group.
Odds of accepting compensation were also significantly lower for serious injury scenarios than for nonsevere injuries, and for surgical-error injury than for diagnostic-error injury, according to the study.
About 71 percent of respondents and 81 percent of the full-compensation group believed the primary reason behind the compensation offer was to avoid a malpractice suit, rather than because the physician felt it was the right thing to do or a way to remedy the physician-patient relationship.
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