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The day after I had minor hand surgery last year to repair a severed nerve, the doctor called me at home to see how I was coping.
I was so surprised - and thrilled - that the surgeon was checking on me that I wrote a thank-you note (with my good hand) before I even knew if the procedure was successful. A simple, unexpected phone call cast the entire experience in a good light.
It's the little gestures that give doctors memorable bedside manners and create a positive patient-physician relationship, which studies show can improve health.
But often, communication between the parties is poor. Patients feel discounted, deserted and misunderstood while doctors work under the pressure of the managed-care system and clam up under the constant threat of lawsuits.
Thanks to astronomical medical malpractice insurance premiums, 72 percent of doctors now view their patients as potential adversaries, according to a survey by Doctors Co., a physician-owned insurance company. Some physicians are taking aggressive measures and asking patients to sign forms agreeing not to sue for frivolous reasons, or filing countersuits.
That rancorous relationship needs to change, says a Southern Illinois advocacy group, Victims and Families United. The best way to do it, the group believes, is to let physicians freely and honestly say the simple words "I'm sorry."
The group supports a proposed pilot program called "Sorry Works!" which is before the Illinois General Assembly. Based on the premise that anger - not greed - fuels malpractice lawsuits, "Sorry Works!" encourages prompt apologies by doctors and hospitals and fair settlement offers after mistakes, to reduce lawsuits.
It would not fully protect a doctor from getting sued and doesn't mean the hospitals would dispense money every time something went wrong. The issue has plenty of gray areas: There is a difference between a mistake and an unintended outcome. Often the standard of care is met and people die or suffer complications anyway. Medicine is a notoriously imperfect science.
But the proposed program, which is part of a bill that has passed the Illinois Senate and awaits action in the House, is a step in the right direction. For a trial period of two years, at two Illinois hospitals, doctors and patients could see whether apologies really do facilitate better communication among doctors, families and their attorneys and fewer lawsuits. So far, the approach has had some success in certain hospitals, such as the University of Michigan and the Veterans Administration Hospital in Lexington, Ky., where it all began in the late 1980s.
"It's a long-term solution to this issue of litigation and medical errors that is good for all sides," said Doug Wojcieszak, the spokesman for Victims and Families United, who lost his brother Jim to medical errors. "Doctors who have complaints about their practice are much more likely to get sued. It's about human interaction. If you treat people right, even when you make a mistake, they give you the benefit of the doubt. If, however, a doctor is arrogant, the patient is more likely to sue."
When apologies are given, the risk of lawsuit is reduced by 50 percent, according to "Healing Words: The Power of Apology in Medicine" (Doctors in Touch, $19.95) by Dr. Michael Woods. He also writes that female doctors are three times less likely to get sued than their male counterparts, likely because they are more in touch with their patients' feelings.
"Arrogance doesn't belong in the medical practice. Arrogance is a setup for getting sued," said Terri Morris, medical director for the division of community health at the University of Illinois at Chicago.
Morris, a pediatrician with lupus, said she nearly died after doctors misdiagnosed a virus several years ago and has seen the issue both as a doctor and a patient.
"No one apologized to me and it was a very frustrating, horrible experience," said Morris. "Two months afterwards, it would have been nice if someone had said, `We're sorry we didn't believe you were sick.' Doctors need to be willing to admit they don't know every manifestation of disease."
Apologies, meanwhile, don't have to strictly be an expression of guilt or used only in life- threatening situations. They can be words of empathy. They can defuse the angry patient who has been kept waiting long past the appointment time. They can be a way for doctors to say, "I'm not perfect."
Today's patients sometimes just want to know their doctor is human and cares about them. An apology - or a phone call - can work wonders in creating the right atmosphere.
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(Julie Deardorff writes for the Chicago Tribune. Write to her at: the Chicago Tribune, 435 N. Michigan Ave., Chicago, Ill. 60611.)
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(c) 2004, Chicago Tribune. Distributed by Knight Ridder/Tribune News Service.
