Professor Argues Against Massachusetts Apology Approach

Last month, the Massachusetts Medical Society (MMS), joined by six healthcare organizations, announced the launch of a new initiative to improve the commonwealth’s medical liability system.

The new alliance collectively created what it refers to as the Roadmap to Reform, an alternative approach to medical liability rooted in the process of Disclosure, Apology and Offer (DA&O) that has proven highly successful at the University of Michigan Health Care System for more than a decade. The new approach is expected to improve patient safety, increase transparency, reduce litigation and cut costs to the commonwealth’s healthcare system.

Under the DA&O model, healthcare professionals and institutions as well as their insurers disclose to patients and families when unanticipated adverse outcomes occur. They explain what happened, establish systems to improve patient safety and prevent the recurrence of such incidents. When appropriate, the healthcare team apologizes and offers fair financial compensation prior to the patient resorting to legal action. This system should not deny patients the right to bring legal action, but rather make tort claims a last resort. Of course, when claims have no merit, they will be robustly defended.

In the wake of the fanfare that surrounded the announcement of the Roadmap to Reform and its implementation, Gabriel, Teninbaum, JD, a professor of legal writing, has come out criticizing the initiative. According to Teninbaum, the new system is rife with opportunity to confuse patients and manipulate them into accepting unfair compensation for medical injury.

Is the manipulation of a patient under the DA&O model a possibility? Yes, but apology in medicine is not a new concept, and it has proven successful in application at the University of Michigan Health System. It’s also a known fact that many patients sue their doctor because they feel the doctor simply didn’t care about their injury or dissatisfaction. When dealt with honestly and with empathy, most patients are less likely to sue their doctor for medical malpractice.

Let’s give this Roadmap to Reform some time to prove whether it is in fact a positive, rather than jump to nefarious conclusions.