New Directions in Medical Liability Reform

Kachalia, Allen

doi:10.1056/nejmhpr1012821

Cited by 104 publications

(71 citation statements)

References 49 publications

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“…1 Several hospital systems and liability insurers have already adopted disclosure-and-resolution programs, through which they inform patients and families of unanticipated adverse outcomes; investigate and explain what happened; apologize; and, where appropriate, offer financial compensation without the patient's having to sue. 2 In 2010 the Agency for Healthcare Research and Quality funded demonstration projects testing the disclosure-and-resolution approach.…”

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confidence: 99%

Disclosure-And-Resolution Programs That Include Generous Compensation Offers May Prompt A Complex Patient Response

et al. 2012

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Under "disclosure-and-resolution" programs, health systems disclose adverse events to affected patients and their families; apologize; and, where appropriate, offer compensation. Early adopters of this approach have reported reduced liability costs, but the extent to which these results stem from effective disclosure and apology practices, versus compensation offers, is unknown. Using survey vignettes, we examined the effects of different compensation offers on individuals' responses to disclosures of medical errors compared to explanation and apology alone. Our results show that although two-thirds of these individuals desired compensation offers, increasing the offer amount did not improve key outcomes. Full-compensation offers did not decrease the likelihood of seeking legal advice and increased the likelihood that people perceived the disclosure and apology as motivated by providers' desire to avoid litigation. Hospitals, physicians, and malpractice insurers should consider this complex interplay as they implement similar initiatives. They may benefit from separating disclosure conversations and compensation offers and from excluding physicians from compensation discussions.

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confidence: 99%

Disclosure-And-Resolution Programs That Include Generous Compensation Offers May Prompt A Complex Patient Response

et al. 2012

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“…112,113 Evaluations of the effects of these reforms have not demonstrated that they have improved the safety of care delivered. 112,113 Indeed, they were not designed to do so. Economic theory would suggest, to the contrary, that reduced liability might reduce incentives for safety.…”

Section: Tort Reformmentioning

confidence: 99%

Legal and Policy Interventions to Improve Patient Safety

2016

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“…Malpractice scholars tend to eschew MICRAstyle reforms as blunt instruments designed mainly to stabilize markets for physicians' malpractice insurance and instead recommend more balanced approaches that prioritize safe care and fair dispute resolution. 21 We believe that a short window of opportunity has opened for major changes to health care delivery, and that the perfect would be the enemy of the good. Over the years, academics have designed many superior alternatives to the existing malpractice system, only to have them go nowhere because of politics.…”

Section: What Kind Of Malpractice Reform?mentioning

confidence: 99%