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Kai Ryssdal: Malpractice hasn't gotten as much attention in the health-care debate as, say, whether or not there should be a public option. Turn the conversation to controlling costs and eventually someone will bring up the topic of how much extra money is spent every year because doctors and hospitals are trying to avoid being sued.
Those extra tests and possibly unnecessary procedures come out of consumers' pockets as they pick up the costs through higher insurance premiums. A health-care overhaul may or may not do something to change that.
Tamara Keith reports, some hospitals and doctors are trying a new approach to malpractice that very well might. It involves just two little words.
TAMARA KEITH: The lobby of Johns Hopkins Hospital in Baltimore is plastered with blown up covers from U.S. News and World Report's best hospitals issue. Hopkins has been featured in it year after year. But even here, doctor and nurses sometimes make mistakes.
MEG GARRET: As many safeguards as we put in place, things do happen.
Meg Garret is the director of risk management at Hopkins. She encourages doctors to say something patients rarely hear. It goes like this.
GARRET: You know I'm really sorry that this happened to you today, and we're going to investigate it. And then it's our policy that once it's been investigated that we clearly know what either went wrong or what the complication is that we have a disclosure to the family.
Where they sit down and talk about what happened.
That kind of conversation, especially the apology, is downright revolutionary. Lawyers for insurance companies and hospitals are so afraid of lawsuits that doctors are often forbidden from talking to patients when something goes wrong. It's all about "deny and defend."
Andy Slutkin, a baltimore malpractice lawyer, says that can be counter productive.
ANDY SLUTKIN: One of the biggest complaints that we get when a client first contacts us is "my doctor wouldn't speak with me" or "I can't get any information from my doctor" or "I don't understand what happened."
And often they're angry. Angry enough to sue. Slutkin regularly works on cases involving Johns Hopkins.
SLUTKIN: When there's open dialogue between the patient and the doctor there's less of a likelihood of that patient coming to a lawyer to find out answers.
KIETH: But you're a lawyer, why are you promoting this?
SLUTKIN: Well, if I were a patient, I'd want my health-care provider to communicate with me and tell me what happened and not avoid me.
Sometimes he says all it takes to keep a case out of court is an apology. That was true for Jennifer Wagner.
JENNIFER WAGNER: What that apology meant to me was that they had listened finally.
This comes from an educational video for doctors created by the University of Michigan Health System. The video is part of a malpractice settlement with Wagner.
Her doctors missed a breast cancer diagnosis. Two years later when it was finally discovered, the cancer had spread and she filed suit. The case was ultimately settled out of court -- worked out in a meeting with hospital lawyers, Wagner, her lawyer and her doctors.
WAGNER: I can't even describe how euphoric I felt when I left that meeting. All of these people had finally listened to me, and I had stood up for myself.
Wagner, who is cancer free, also received a cash settlement of about $400,000. But it was far less than what hospital system lawyers feared she might get in court.
Richard Boothman is the system's chief risk officer.
RICHARD BOOTHMAN: Let's just cut through the baloney, and we should just step up and take care of those cases where a true medical mistake was created.
Since Boothman took over in 2002, the University of Michigan Health System has been able to cut its malpractice insurance cash reserves to $13 million, from more than $70 million.
Some critics believe that apologizing may be better for the doctor than it is for the patient.
Marc Cohen is a malpractice lawyer. He says a doctor at Johns Hopkins tried to apologize to his family after his daughter Brianna died.
MARC COHEN: We were all devastated. The last thing we needed was an apology from the folks that created this terrible tragedy.
Cohen thinks in many cases apologies aren't really about making patients and their families feel better.
COHEN: I truly believe that the apology is an effort to make victims of malpractice go away.
But in some cases, "I'm sorry" is all they were ever after.
I'm Tamara Keith for Marketplace.