MEDICAL MISTAKES: Honesty Can Limit Malpractice Costs

      Contradicting widespread provider assumptions that admitting medical errors is unwise, a study in today's issue of the Annals of Internal Medicine suggests that hospitals can actually limit the costs associated with malpractice suits by reporting mistakes to patients or their families as soon as possible and offering reasonable compensation. The study compared the total liability payments made by the Lexington, KY-based Veterans Affairs Medical Center -- which in 1987 implemented a policy of "extreme honesty" calling for full disclosure of all errors -- with those of 35 similar veterans hospitals from 1990 to 1996. The results: The Kentucky hospital paid less than all but six other facilities.

Ethically Correct, Cost-Effective
      Under the policy, a risk management committee investigates cases that may involve malpractice and advises the patient or next of kin if it finds that an error by hospital staff resulted in harm to the patient. Hospital officials noted that the voluntary disclosure system is founded on the practice of self-reporting of errors, to which physicians and nurses have responded enthusiastically (Bergstrom, AP/Lexington Herald-Leader, 12/21). In an editorial that accompanied the study, the medical journal called on hospitals in the private sector to adopt similar disclosure policies, calling the approach the "rare solution that is both ethically correct and cost-effective" (Gerlin, Philadelphia Inquirer, 12/21).