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Published: Friday, 5/14/2004

Admitting medical mistakes

ALLOWING physicians to admit their mistakes is saving money on medical malpractice lawsuits for the giant University of Michigan Health System and could be at least a partial answer to the problem of rising malpractice insurance premiums.

The strategy reportedly has cut attorney fees for malpractice actions against UM's billion-dollar health-care conglomerate in Ann Arbor by about two-thirds over the past two years, from $3 million a year to $1 million, and has similarly reduced the time it takes to settle complaints.

Although there is controversy about the correlation, skyrocketing jury awards and settlements in medical cases often are cited as unfairly inflating the cost of malpractice insurance for physicians. As a result, some doctors are choosing to leave the business or opt for less-risky specialties.

Admitting a mistake that injures a patient might seem like a drop of blood in the water to the sharks among malpractice attorneys, but it does reflect reality. Medical mistakes happen, more often than anyone would care to admit.

A 2001 study by the national Institute of Medicine said that some 98,000 Americans die in hospitals each year from errors by medical personnel. That's a truly frightening number, the equivalent of losing a city the size of Dearborn - every year - because of medicine practiced badly.

UM's tactic has been to admit it when a mistake happens, for physicians to actually apologize directly to patients, and to compensate victims without the need to go to court. As Rick Boothman, the system's assistant general counsel, told the Detroit News, "The best thing is to be error-free, and the next best thing is to make it right as quickly as possible and make sure it doesn't happen again."

Contrary to the traditional "see you in court" attitude that often extends disputes, UM officials actually invite potential malpractice claimants to talk to the system's lawyers.

The other side of the strategy is steadfastly refusing to cave in to demands for monetary settlements when injury claims are unfounded. "We will not pay for cases that don't have medical merit," Mr. Boothman said. "You have to stand up for your principles both ways."

Such a program can only succeed, of course, if there are honorable people on both sides of the negotiating table. When it comes to malpractice disputes, that may be a utopian goal.

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