Honesty with infected pt irks colleague
A surgical site infection, an antibiotic question
Doing the right thing doesn't guarantee that everyone is going to be pleased, says Frederick S. Southwick, MD, professor of medicine in the Division of Infectious Diseases and quality projects manager for the senior vice president for health affairs at the University of Florida Shands Health in Gainesville.
Shands has a policy of transparency when it comes to medical errors, Southwick explains. When an error occurs, the policy is to immediately inform the patient and offer restitution. The result has been a marked reduction in malpractice insurance premiums, Southwick says.
"Legal fees have plummeted, and the money they spend goes to the people who deserve remuneration: the injured patient and their family," he says. "Under the standard approach, over 60% of malpractice funds go to the lawyers."
Southwick once encountered a situation in which he had to disclose to a patient that an error had occurred under previous care by another physician, and he says the experience shows how difficult that can be.
"As an infectious disease consultant, I was asked to see a patient who had a severe postoperative infection after a prolonged delay in the initiation of antibiotics. The patient asked me if he should have been treated earlier, and in the spirit of honesty and openness, I told him, yes he should have been treated earlier," Southwick says. "I then informed the physician who had consulted me about the patient's concerns, and we together contacted our risk management team. They in turn discussed in detail the patient's concerns with him, and they forgave his hospital bills and provided him with compensation for his lost time at work."
The patient was satisfied, he says, but the other physician's initial reaction was not positive. "The physician who inadvertently delayed the initiation of antibiotics was unhappy with my response, but after I explained that this strategy would greatly reduce the likelihood of a malpractice suit, he understood my approach, and we remained friends and close colleagues," he says.