Governor is expected to sign bill that keeps statements of concern out of court.
There may be a good reason patients sometimes feel they get the cold shoulder from their doctors after being injured in a medical setting.
The physicians may be afraid that even the slightest expression of concern or sympathy for the patient’s pain might be used against them in court.
That fear could be alleviated in a bill Gov. Tom Corbett is expected to sign Wednesday after it passed the state House of Representatives on Tuesday. The “benevolent gesture” legislation would allow doctors to offer words of apology, condolence, explanation, compassion or commiseration to patients without fear of their words coming back to haunt them in court.
The House passed the bill 202-0. The Senate approved the measure unanimously in June.
“Medicine is not an exact science, and outcomes may be unpredictable. Benevolent gestures are always appropriate and physicians should not have to fear giving them,” said Dr. C. Richard Schott, president of the Pennsylvania Medical Society. With passage of the bill, “doctors will feel more comfortable doing so, knowing that an apology is inadmissible unless their expression admits fault.”
The bill, which is part of Corbett’s Healthy PA initiative, took eight years to get through the Legislature, said prime sponsor Sen. Pat Vance, R-Cumberland County. She said she had no “hard core” evidence that doctors’ expressions of apology had been used against them in the past. Rather, the issue was more about doctors’ fears that their statements would be used against them, she said.
Despite that lack of evidence, there may be a correlation between physician apologies and fewer malpractice complaints. Studies have shown states that protect physicians’ statements of apology have seen a drop in malpractice suits, although it is not clear if the laws caused the drop in lawsuits.
In one example, the University of Michigan Health System found that the monthly rate of new liability claims dropped from 7.03 per 100,000 patient encounters to 4.52 per 100,000 after its doctors began issuing apologies, according to a 2010 study published in the Annals of Internal Medicine. The number of filed malpractice lawsuits and the total cost of those lawsuits also declined, it said.
The Journal of the American Osteopathic Association in 2012 also said a number of studies found a positive connection between apologies and lower legal costs. “A simple apology allows physicians to remain true to their honesty and integrity while exhibiting their humanity and providing some much-needed closure to their patients and their patients’ families,” it said.
“I could understand why a doctor would be reluctant to say words such as ‘I’m sorry,’ ” Bethlehem Township attorney Mark Altemose said. “Certain people could interpret that as meaning somehow they were at fault.”
At the same time, Altemose said, many patients have come to his office angry that the doctor didn’t express an apology at a bad outcome. They feel they have no choice but to take the matter to court, he said. A simple statement of apology would improve the doctor-patient relationship and “absolutely” lead to less malpractice litigation, he said.
“It may actually reduce the number of malpractice cases that are filed,” Altemose said.
The bill covers not only physicians but also health-care workers in hospitals, nursing homes, birth centers, ad nursing or personal care homes.
The bill would not protect statements of negligence or fault. So if a physician admits to a patient that he operated on the wrong part of a patient’s body and is sorry for it, Altemose said, the apology would not be admissible in court, but the admission would.
According to Vance, 37 states already have apology protection for physicians.
“The patients are winners because they at least know that their caregiver cared about them,” Vance said.