In an effort to cut down on the costs, time and emotional turmoil of medical liability cases, a new wave of legal proceedings has been suggested and may soon be under way. Four years ago, Bystate Health was part of a large effort to pioneer a disclosure and apology initiative in which patients that have experienced harm at the hands of a medical professional will be given precisely what they need to make a full recovery: disclosure, apology and offer. Referred to among medical professionals as DA&O, patients are provided with full disclosure of what happened, including why it happened, as well as what can be done to prevent it from occurring again in the future. For events determined as ones that could have been avoided, not only will a timely offer of compensation be made, so too will a sincere apology be expected.

The DA&O plan comes after a long history of medical malpractice cases in which patients were unfairly treated and mis- or under-represented, leading to complicated court process and tort claims totaling many years of legal proceedings. It has been estimated that the average medical malpractice lawsuit can take anywhere from five to seven years, sometimes lasting as long as ten years. Thousands of hours must be dedicated to depositions and testimonies, and the dollar amount of such cases is often excessively high – sometimes completely unaffordable. Hence the need for change, an initiative that some are taking with more stride than others. Physicians have openly and loudly expressed their criticisms of the new DA&O plan, claiming that it fosters unwarranted and unnecessary lawsuits. Some medical professionals also believe that the plan actively undermines patient safety and even reduces their access to care.

According to opposing physicians, the Disclosure, Apology & Offer plan does nothing more than create a culture of oppression – possibly even silence – between physicians and their patients, while further bombarding doctors with extremely high insurance premiums that are nothing more than burdensome. In addition, some have claimed that the plan drives the practice of defensive medicine, encouraging tests and procedures taken purely to protect a medical professional from the potential of a lawsuit, rather than out of true need. In effect, health costs will be increasingly higher, physicians warn. However, these warnings must be taken with a grain of salt, as they are serving the best interests of the physicians, and not necessarily the patients themselves.

DA&O has been described by some professionals in the field as the newest addition to the patient safety movement. Allowing for the transparency and sharing of information among cases of medical error, the new system would allow everyone to learn of such errors and how to prevent them. It is believed that the current system does nothing more than encourage silence among providers, while at the same time minimizing their willingness to learn from previous errors. However, under the new approach, a much greater potential for change exists. As such, some health systems have followed in the efforts made by Bystate Health, including various systems in Massachusetts which will pilot their own DA&O programs in the Commonwealth. In total, seven more healthcare systems have aligned to take part in the Roadmap to Reform, which will work to improve patient safety through transparency and trust. It is hoped that this will also reduce litigation and curb the costs of health care among those who need it most.

Under the new model, cases stand to be resolved faster in addition to the noted benefits that have already been described above. It is also anticipated that the new system will allow for an enhancement of medical error reporting and will also result in a reduction in the practice of defensive medicine among too many professionals in the field. Devoted to pursing a better way of serving patients in need, advancing their safety and protecting them from manipulation, Disclosure, Apology & Offer is certainly leading the trend in new medical malpractice operations within the legal system. As such, all stakeholders, physicians, hospitals, policymakers, insurers and patients are encouraged to join the healthcare providers that have already signed on to the project. Together, it is believed that a substantial improvement can be made with n the health field – one that is not only long overdue but also highly beneficial to all parties involved.