The document discusses the Sorry Works! Coalition, which promotes a program of full disclosure and apology when medical errors occur. The program aims to reduce litigation by handling issues compassionately and compensating harmed parties. Data suggests programs like those used in Canada and the US lower costs from fewer lawsuits and settlements. While some remain cautious of apologies due to liability concerns, the coalition argues real apologies do not increase legal risks when part of an organized program with thorough investigations and compensation when appropriate.

1. The Sorry Works! Coalition Doug Wojcieszak 618-559-8168 [email_address] www.sorryworks.net

2. Brief background on The Sorry Works Coalition Formed in February 2005 in response to medical malpractice crisis in the United States. Third way to nasty, divisive fight and we are having great success. Doctors, hospitals, insurers, and lawyers beginning to embrace. If it can work in this climate, it can work anywhere!

3. Goals of the Coalition Goal #1: Education Goal #2: Organizing the full-disclosure movement Goal #3: Legislative activities; however, don’t really need legislation! (discuss later)

4. Thesis of The Sorry Works! Coalition American medical malpractice lawsuit crisis is a customer service crisis that has been miscast as a legal problem to be fixed by politicians. American med-mal crisis can be fixed anytime by medical professionals with good customer service principles. True of most legal disputes: 1) unhappy customers/taxpayers and 2) good customer service is the solution!

5. Educational message Sorry really does work ! Lexington VA hospital/all VA hospitals University of Michigan/Stanford University, and Harvard Teaching Hospitals Kaiser hospitals (28 hospitals) Minneapolis Children’s Catholic Healthcare West (40 hospitals) COPIC Insurance And others….

6. Program description Not a policy! Sorry Works! is a program and process, not unlike what Canadian Ombudsman normally do. People are trained and the institution embraces this approach. Insurance carrier, all players on board with program ahead of time!

7. Program description Bad outcome – unexpected death, surgery or treatment did not produce expected results, etc Root cause analysis – several weeks to four months – was the standard of care met? Stay in close contact with patient/family during analysis– return all phone calls promptly and pleasantly

8. Program description cont’d Root cause analysis shows standard of care not met = error(s) or negligence Set meeting with patient/family and attorney Apologize and admit fault Explain what happened and fix Offer upfront compensation

9. Program description cont’d Root cause analysis shows standard of care was met = no error(s) or negligence Still meet with patient/family and attorney Empathize, answer questions, open records – prove innocence “Honesty Dividend”

10. Three main principals: Compensate quickly and fairly when inappropriate medical care causes injury Defend medically appropriate care vigorously. Reduce patient injuries (and therefore claims) by learning from mistakes. - source: Univ. of Michigan

11. Sorry Works! Savings Anger reduced = fewer lawsuits, lower settlements Defense litigation costs down; cases closed in months instead of years Non-meritorious cases reduced Medical errors reduced

12. Applicability to Canada? Sorry Works! works in America, but what about Canada?

13. Canadian Applications “… . an apology so often diffuses emotions and breaks down barriers to a settlement. An apology can also help preserve relationships.” - Terry Harris Vice President British Columbia Mediator Roster Soc. March 28, 2006

14. Canadian Applications “ In place of an apology, some officials are willing to express their regrets, but regrets may not satisfy a person’s need for apology….saying “I am sorry” often allows a person to forgive and move on.” - Howard Kushner, Acting Prov. Omb. February 8, 2006

15. Canadian applications “ My experience as Ombudsman has demonstrated to me the power of apology in settling disputes….However, too often I hear from public agencies that they will not apologize, for fear that their apology will be used against them as acknowledgement of liability in any potential civil action.” - Howard Kushner, Acting Prov. Omb. February 8, 2006

16. Canadian applications “… apologies are not fully embraced within our (Canadian) legal culture….lawyers continue to be concerned that an apology could be construed as an admission of liability. An apology could also have adverse consequences for insurance coverage. As a result, lawyers generally advise their clients to avoid apologizing.” - B.C. Ministry of A.G. January 30, 2006

17. Canadian applications Seems there is interest across Canada in “safe” apology laws. Two Canadian provinces have such laws. 29 American states have laws “protecting” apologies or disallowing their use in civil proceeding for medical professionals. Australia has similar apology laws.

18. Quotables “ I would never introduce a doctor’s apology in court. It is my job to make a doctor look bad in front of a jury, and telling the jury the doctor apologized and tried to do the right thing kills my case.” - President, South Carolina Trial Lawyers Assoc.

19. Another quotable… “ No case will be settled until all billable hours have been achieved by the defense attorney.” Risk Manager from an American Hospital

20. So do you need a law to apologize in Canada or the United States? Short answer: “No” Apology when done right will never hurt you in court or elsewhere Apology laws are great PR tools but have little legal value How can we say this?

21. Important questions no one asks! What causes customers/taxpayers to want to file a lawsuit? What makes juries and judges side with a plaintiff and provide a large verdict? Answer: ANGER, not greed.

22. 2 nd important question not asked What motivates a plaintiff’s attorney? An error or mistake is a start, but usually not enough to make a case in court. PI attorneys also want to see a cover-up, poor customer service, etc. This is the “plus factor” that angers jurors and judges and leads to big verdicts. No plus factor, cases get settled or never even filed

23. Anger, cover ups, and poor customer service Sorry Works! removes anger from customers/taxpayers. Sorry Works! alleviates concern of cover-up and demonstrates good customer service, and will take wind out of cases.

24. To be effective, though… Sorry Works! has to be real, meaningful. Four Elements of real apology: “Sorry” Admission of fault Explanation of what happened/reform Fair compensation

25. Words of caution Without the four elements of real apology, you could be in trouble in court: Use “weasel words” like regret Don’t accept responsibility No explanation, no promises of reform No compensation or effort to make amends. Increase – not decrease – anger Increase chances of expensive litigation

26. To do apology right, we advocate a disclosure/apology program Key leaders in institution or business trained in how to disclose/apologize. Rolled out to entire institution/business so everyone understands and embraces concept Insurance carrier brought on board ahead of time as are defense lawyers.

27. When something bad happens… Program snaps to work… Injured party approached with customer service framework. Sympathize, empathize, and say “sorry.” Only say what we know. Begin re-establishing communication and trust.

28. When something bad happens.. Do thorough, credible investigation. Share results with injured party and their attorney. If you made mistake, say sorry, admit fault, and compensate. Compassion. If you didn’t make a mistake, say sorry, prove your innocence, but don’t compensate and fight any litigation. Never settle. Backbone.

29. Arar story “ Apology law would allow PM to say sorry to Arar.” (9/28/06, CanWest News Service) “ Prime Minister Stephen Harper issues a formal apology to Maher Arar while announcing Arar will receive $12.5 million in compensation.” (1/26/07, CBC News).

30. Summary Apologies are always “safe” and “legally wise” when done right in the auspices of a program. Don’t need law to apologize. Sorry Works! is compassion with a backbone. Sorry Works! is good customer service – most important factor!

31. Thank you for listening For more information visit our website: www.sorryworks.net Or contact Doug Wojcieszak at 618-559-8168 or [email_address] Share our website – www.sorryworks.net – with friends. Thank you!