Mediation can avert malpractice suits

Commentary. By Leonard J. Marcus, PhD, and Barry C. Dorn, MD, AMNews contributors. June 17, 2002.

COMMENTARY

Observations on the state of medical practice and medical life

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As would be expected, the headline nature of the crisis has spawned a plethora of potential solutions, many based on law. Therefore, laws have been proposed to curb the legal process and limit the amount of settlements. These efforts at tort reform are laudable and long overdue. But it would be a mistake to limit the discussion to just matters of changing the law.

Medical practice, bottom line, is about doctors giving, and their patients receiving, a quality, life-saving service. A medical malpractice case most often results from something going wrong in that process or in its outcome. That problem is then transformed into a dispute over money -- the plaintiff wanting a high figure and the defendant or his or her insurer wanting to provide less than what is demanded. Enter the civil justice system and with it an elaborate, expensive and time-consuming process to manage and resolve the dispute.

But to assume that this crisis is merely a matter of money is to miss a number of other potential solutions. This might be the opportunity to consider finding new ways to resolve disputes. These options could contribute to efforts that improve the quality of patient care so that, in the long run, there are fewer cases headed toward legal confrontation.

The consideration and adoption of effective dispute-resolution options is now hindered by assumptions about patients, communication and quality.

Physicians are often counseled not to talk to patients after a bad outcome. It is assumed that patients are only out to get them. The process assumes the tone of little more than a "blame game." Here are three projects that counter these assumptions. [...]