ATLANTA—Hospital staff and physicians who are willing to explain, apologize for and resolve adverse medical events significantly reduce legal defense and liability costs, according to a study led by Dr. Florence R. LeCraw, an Atlanta anesthesiologist and adjunct professor at Georgia State University.
LeCraw and economist Thomas Mroz of Georgia State’s Andrew Young School of Policy Studies, health economist Daniel Montanera from the J. Mack Robinson College of Business and medical and risk management experts from the Erlanger Health System in Chattanooga, Tenn., examined 12 years of data (2004-2015) at Erlanger, a five-hospital system that treats 600,000 patients annually. Doctors at Erlanger are not employed by the hospital, and they purchase their own professional liability insurance.
The study, published this year in the Journal of Patient Safety and Risk Management, found that Erlanger’s Communication and Resolution Program (CRP), initiated in January 2009, led to a 66 percent reduction in legal claims filed, a 51 percent reduction in defense costs and a 53 percent reduction in the time required to close cases. No medical error occurred in 65 percent of the adverse events reported.
“Following CRP protocol, when medical errors were explained to the patients and their families, 43 percent were resolved by apology alone, even though 60 percent of those patients had legal representation,” Dr. LeCraw said.
The study’s findings led John Antalis, M.D., leader of the Medical Association of Georgia, to submit a resolution to the American Medical Association to endorse the communication and resolution program as a viable malpractice resolution practice, Dr. LeCraw said. The study also was cited when the American Medical Association’s House of Delegates voted to adopt a resolution supporting CRP at its November 2017 meeting.
“The AMA vote and the results from our study add further confirmation that apologizing to patients for bad outcomes from medical error through CRP isn’t just the right and honorable thing for physicians to do, it greatly reduces legal costs, stress and the needless, costly practice of defensive medicine by physicians,” Dr. LeCraw said. “This protocol, in contrast to the ‘deny and defend’ legal approach to medical error, accelerates the process of improving the quality of healthcare delivery by empowering everyone to communicate openly and transparently about what went wrong and to focus quickly on how such episodes can be prevented in the future.
“Our contribution to the growing literature on CRPs clearly demonstrates how following this protocol can benefit patients and physicians, lower healthcare costs and improve the quality of healthcare. We hope these improved liability outcomes may encourage more physicians and medical facilities to support communications and resolution programs.”
Florence LeCraw, M.D.
Dr. Florence LeCraw is a practicing anesthesiologist in Atlanta and an adjunct professor in the Andrew Young School of Policy Studies at Georgia State University. Her specialty is health economics with an emphasis on patient safety and malpractice reform. Dr. LeCraw holds a B.S. from the University of Georgia and a medical degree from the Medical College of Georgia. She did her residency in anesthesia at Vanderbilt in Nashville.