The focus of so many risk management courses for doctors has been about the old standard of document, document, document. How many CME courses have you sat through drilling you with this worthy defensive motto? As important and essential as good documentation is, we want to present another side of the equation, and another motto: communicate, communicate, communicate. This is a patient-friendly stance that the idealists among us may say could cure any adverse relationship between a patient and their medical provider. There will always be unwanted patient outcomes in any medical practice, but open communication will certainly help to limit any developing crises.
Communication is about doing the right thing for the doctor / patient relationship, not just about making sure you document as a means to avoid lawsuits. This must be two-way communication in order to make sure that your patients voice is heard as clearly as yours. Any fears or expectations must be discussed openly and freely between you and your patients. When this type of open communication exists, then the doctor / patient relationship is so strong that any need to pursue a legal action is weak by comparison. Patients who sue their medical provider will ALWAYS have some communication breakdown to report in the complaint portion of their lawsuit. Medical practices are always at risk of lawsuits, but likewise, open communication will always limit the severity of any bad outcome. The fundamental communication with patients needs to be how much you care about them. Sir William Osler, often called the most influential physician in history, put it so eloquently when he said that “Patients dont care how much you know until they know how much you care.” This helps to explain why patients who feel uncared for are more likely to sue no matter how superbly trained and well documented their physician is. You can see similar examples of how you relate to your most trusted advisors in every day business affairs. Most likely you stay with them because you know they care about you, more so than because of the actual level of experience they may have. The top ten patient satisfaction elements are concern, friendliness, patience, sincerity, consideration, availability, technical quality of care, outcome, cost, and practice environment. Please read them again and note that almost all of these are benchmarks of caring and each can be helped considerably by clear communication and managing the patients expectation. Patients who are satisfied with their physicians relationship are much less likely to sue even when they are not satisfied with the outcome of their health. Many lawyers hear from plaintiffs that they do not want to sue a certain member of their team of doctors because they like them. They like them because they felt cared for, which sounds simple and rhetorical, but that is the point. The vast majority of doctors deeply care about their patients, but only some know how to effectively communicate their caring and concern. According to risk management experts, up to seventy-five percent of lawsuits can be attributed to some form of communication issue and not to any misdiagnosis or surgical mistake. The great news about this rather astounding view is that this means that the majority of these relationship problems can be prevented. Think what a difference you can make in your patients and your own satisfaction by limiting the source of their complaints. Great communications is vital for every practice. Every sincere expression of caring is a powerful place to begin your risk management efforts.
