Summary
As director of medical-legal affairs for Kaiser Permanente in northern California, Dr. Bruce Merl sometimes observes by video monitor, with the patient's permission, as a doctor talks with the person about a medical treatment that has not gone well. The bad news most often is the result of chance, but sometimes it may be the result of a medical mistake. Either way, the resulting conversation is likely to be tense and painful. But Merl and the HMO have discovered a solution that seems to help both the injured patient and the doctor to make amends and move on from medical mishaps. And in the process, he hopes, it may also enable Kaiser Permanente to control its litigation costs. Last year, as part of its policy of disclosing information to patients, the HMO began training its 11,000 physicians how to apologize personally to patients for whatever suffering they've experienced, and to assure them that amends will be made if necessary.
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Extract
The Art of the Apology
AS DIRECTOR OF MEDICAL-LEGAL AFFAIRS for Kaiser Permanente in northern California, Dr. Bruee Merl sometimes observes by video monitor, with the patient's permission, as a doctor talks with the person about a medical treatment that has not gone well. The bad news most often is the result of chance-failure to respond to a standard medication or a belated diagnosis of cancer that initially evaded tests-but sometimes it may be the result of a medical mistake. Either way, the resulting conversation is likely to be tense and painful. "The patient is worried about what's going to happen to him, who's going to help him get better," Merl says. The doctors are worried, too, and not just about the possibility of a malpractice lawsuit. "Nobody comes to work thinking that they're going to harm someone. They feel lost and seare...
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