I recently came across this article in the New York Times that describes a new movement among doctors and hospitals to admit their mistakes rather than continue with the more traditional approach of denying and defending them. As a result, the article suggests, these hospitals are seeing a decline in lawsuits and legal costs. I suspect that this has something to do with the fact that in these hospitals the patients are being treated with an approach that is usually reserved for meaningful, social relationships.
Why? We live in two worlds. The first is governed by social norms, which generally implies that all parties involved share a level of trust and a general understanding that everybody will act with the best intentions, bearing in mind the well being of others in addition to their own. In this social world, small transgressions are usually acknowledged and both parties work together to respectfully fix the situation in a manner that does the least damage to the other. The second world is generally governed by market norms-things like contracts, numbers, and hard facts. In this world both parties tend to be so concerned with sticking to the terms outlined in a contract that the slightest transgression is treated without an ounce of empathy often causing it to evolve into something larger. After all it is a violation of the contract. In this world intentions do not matter and it is only actions that count-you are either fulfilling your contract or you are not.
I suspect that the doctors and the hospitals that have enacted these disclosure policies, have tapped into the power of operating in accordance with social norms so that both the doctor and the patient can work together to prevent a bad situation from becoming worse.
Of course, this disclosure approach is not a panacea, because some patients will still get upset in the social realm and will file a lawsuit (and armed with their doctor’s admittance to a mistake, they might in fact get more money out of the hospital). But, I suspect that this approach will reduce the number of lawsuits to a larger degree than the increase in payment for the remaining ones. I also suspect that it will have a long-term positive effect on the patient-doctor-hospital relationship.