Disclosure Not a Risk Management Tool? Not About Avoiding Lawsuits?
I have often heard friends and colleagues in the disclosure movement claim that disclosure is not a risk management tool. Nor is it about avoiding lawsuits, say these well-intentioned souls. They assert, instead, it's all about doing the right thing, or strictly for patient safety purposes.
There is even a group of healthcare professionals who have attempted to rename disclosure -- or Sorry Works! -- as "Communication and Resolution" or Communication & Resolution Programs, or CRP for short. These folks claim their CRP slogan is more descriptive, but they also swear it is a patient safety program, not a risk management tool.
I am sorry, but the very word "resolution" in a healthcare setting (acute or long-term care) typically implies risk, claims, legal, or c-suite (i.e, the usual suspects in a med-mal case). Sorry, guys...."CRP" screams risk management.
Moreover, when we claim disclosure is not a risk management tool or is not focused on reducing litigation, I think we are being incredibly dishonest with ourselves and our patients and families, and straining our credibility with the plaintiff's bar. If we are truly going to be transparent, then let's be transparent with our intentions, desires, and goals. Some of our brightest stars -- Boothman, McDonald, etc -- have publicly touted their claims data and reduction in lawsuits before the media, government officials, and healthcare, insurance, and legal professionals, so, how can we in a credible way spin around and say, "Oh, no, disclosure has nothing to do with risk management or avoiding lawsuits...it's just...er....well.....a patient safety program!"
This makes us look deceptive to consumers and trial lawyers, and also sends confusing messages to the population of healthcare, insurance, and legal professionals who still need to be converted to the disclosure movement.
If you really wanted to be cynical, a person could suggest that this whole notion of disclosure being just a patient safety program is nothing more than a big rip-off for patients and families. You know, tell the family you're sorry and show how the mistake will never occur again, play to their altruistic emotions, and, gee, maybe we can get out without paying a nickel for claims that do have economic value. Just sayin'....
To be totally transparent and honest from my end, I get really scared when doctors and lawyers experiment with marketing and public relations. Marketing for most docs is a billboard proclaiming their greatness or they are accepting new patients...and have you looked at lawyer websites or advertisements lately?
For God's sake, quit playing games with words -- that's what lawyers have done far too long with med-mal -- and just be honest with patients, families, the public, the trial bar, and ourselves. Disclosure IS about risk management and reducing the need for litigation, but in an ethical and fair manner.
I think the person who best addressed this topic was disclosure advocate Leilani Schweitzer when she penned a column for Sorry Works! In that column (I am paraphrasing), Leilani wrote that yes, we are trying to avoid lawsuits, but we are not trying to avoid responsibility. Here's Leilani's column.
You know who else is trying to avoid litigation? Patients and families! Litigation is fun for nobody, and, as a family member, if I hear that a hospital or nursing home has a pro-active risk management department that wants to meet my emotional and financial needs, I will say hooray. Be honest with people.
Yes, disclosure has incredible ramifications for patient safety, but it does so because we effectively address the litigation issue, which is a huge impediment to patient safety. To avoid litigation and increase patient safety, we need to get people talking post-event, and nothing does that better than disclosure. Let's just be honest about what disclosure is...
The disclosure movement should not run from its risk management roots, we should proudly share the claims data, and we should not be embarrassed or ashamed about diminishing the need for litigation. It's called being smart....we just have to be honest about it.
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