The Sorry Works! The Sorry Works! CoalitionCoalition

Doug WojcieszakDoug Wojcieszak618-559-8168618-559-8168

doug@sorryworks.netdoug@sorryworks.netwww.sorryworks.netwww.sorryworks.net

Brief background on Brief background on The Sorry Works CoalitionThe Sorry Works Coalition

Formed in February 2005 in response Formed in February 2005 in response to medical malpractice crisis in the to medical malpractice crisis in the United States.United States.

Third way to nasty, divisive fight and Third way to nasty, divisive fight and we are having great success. we are having great success.

Doctors, hospitals, insurers, and Doctors, hospitals, insurers, and lawyers beginning to embrace.lawyers beginning to embrace.

If it can work in this climate, it can If it can work in this climate, it can work anywhere! work anywhere!

Goals of the CoalitionGoals of the Coalition

Goal #1: EducationGoal #1: Education

Goal #2: Organizing the full-disclosure Goal #2: Organizing the full-disclosure movementmovement

Goal #3: Legislative activities; Goal #3: Legislative activities; however, don’t really need however, don’t really need legislation! (discuss later)legislation! (discuss later)

Thesis of The Sorry Works! Thesis of The Sorry Works! CoalitionCoalition

American medical malpractice lawsuit American medical malpractice lawsuit crisis is a customer service crisis that has crisis is a customer service crisis that has been miscast as a legal problem to be been miscast as a legal problem to be fixed by politicians.fixed by politicians.

American med-mal crisis can be fixed American med-mal crisis can be fixed anytime by medical professionals with anytime by medical professionals with good customer service principles. good customer service principles.

True of most legal disputes: 1) unhappy True of most legal disputes: 1) unhappy customers/taxpayers and 2) good customers/taxpayers and 2) good customer service is the solution! customer service is the solution!

Educational messageEducational message

Sorry really does Sorry really does workwork! ! Lexington VA hospital/all VA hospitalsLexington VA hospital/all VA hospitals University of Michigan/Stanford University, University of Michigan/Stanford University,

and Harvard Teaching Hospitalsand Harvard Teaching Hospitals Kaiser hospitals (28 hospitals)Kaiser hospitals (28 hospitals) Minneapolis Children’sMinneapolis Children’s Catholic Healthcare West (40 hospitals)Catholic Healthcare West (40 hospitals) COPIC InsuranceCOPIC Insurance And others…. And others….

Program descriptionProgram description

Not a policy! Not a policy! Sorry Works! is a program and Sorry Works! is a program and

process, not unlike what Canadian process, not unlike what Canadian Ombudsman normally do. Ombudsman normally do.

People are trained and the institution People are trained and the institution embraces this approach.embraces this approach.

Insurance carrier, all players on Insurance carrier, all players on board with program ahead of time! board with program ahead of time!

Program descriptionProgram description

Bad outcome – unexpected death, surgery Bad outcome – unexpected death, surgery or treatment did not produce expected or treatment did not produce expected results, etcresults, etc

Root cause analysis – several weeks to Root cause analysis – several weeks to four months – was the standard of care four months – was the standard of care met? met?

Stay in close contact with patient/family Stay in close contact with patient/family during analysis– return all phone calls during analysis– return all phone calls promptly and pleasantlypromptly and pleasantly

Program description cont’dProgram description cont’d

Root cause analysis shows standard Root cause analysis shows standard of care not met = error(s) or of care not met = error(s) or negligencenegligence

Set meeting with patient/family and Set meeting with patient/family and attorneyattorney

Apologize and admit faultApologize and admit fault Explain what happened and fixExplain what happened and fix Offer upfront compensationOffer upfront compensation

Program description cont’dProgram description cont’d

Root cause analysis shows standard Root cause analysis shows standard of care was met = no error(s) or of care was met = no error(s) or negligencenegligence

Still meet with patient/family and Still meet with patient/family and attorneyattorney

Empathize, answer questions, open Empathize, answer questions, open records – prove innocencerecords – prove innocence

““Honesty Dividend”Honesty Dividend”

Three main principals:Three main principals:

Compensate quickly and fairly when Compensate quickly and fairly when inappropriate medical care causes inappropriate medical care causes injuryinjury

Defend medically appropriate care Defend medically appropriate care vigorously.vigorously.

Reduce patient injuries (and Reduce patient injuries (and therefore claims) by learning from therefore claims) by learning from mistakes.mistakes.

- source: Univ. of Michigan - source: Univ. of Michigan

Sorry Works! SavingsSorry Works! Savings

Anger reduced = fewer lawsuits, Anger reduced = fewer lawsuits, lower settlementslower settlements

Defense litigation costs down; cases Defense litigation costs down; cases closed in months instead of yearsclosed in months instead of years

Non-meritorious cases reducedNon-meritorious cases reduced Medical errors reducedMedical errors reduced

Applicability to Canada?Applicability to Canada?

Sorry Works! Sorry Works! worksworks in America, but in America, but what about Canada? what about Canada?

Canadian ApplicationsCanadian Applications

“…“…..an apology so often diffuses emotions an apology so often diffuses emotions and breaks down barriers to a settlement. and breaks down barriers to a settlement. An apology can also help preserve An apology can also help preserve relationships.”relationships.”

- Terry Harris- Terry Harris

Vice PresidentVice President

British Columbia Mediator Roster British Columbia Mediator Roster Soc.Soc.

March 28, 2006March 28, 2006

Canadian ApplicationsCanadian Applications

““In place of an apology, some officials are In place of an apology, some officials are willing to express their regrets, but regrets willing to express their regrets, but regrets may not satisfy a person’s need for may not satisfy a person’s need for apology….saying “I am sorry” often allows apology….saying “I am sorry” often allows a person to forgive and move on.”a person to forgive and move on.”

- - Howard Kushner, Acting Prov. Omb.Howard Kushner, Acting Prov. Omb.

February 8, 2006February 8, 2006

Canadian applicationsCanadian applications

““My experience as Ombudsman has My experience as Ombudsman has demonstrated to me the power of apology demonstrated to me the power of apology in settling disputes….However, too often I in settling disputes….However, too often I hear from public agencies that they will hear from public agencies that they will not apologize, for fear that their apology not apologize, for fear that their apology will be used against them as will be used against them as acknowledgement of liability in any acknowledgement of liability in any potential civil action.”potential civil action.”

- - Howard Kushner, Acting Prov. Omb.Howard Kushner, Acting Prov. Omb.

February 8, 2006February 8, 2006

Canadian applicationsCanadian applications

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

- B.C. Ministry of A.G.- B.C. Ministry of A.G.

January 30, 2006January 30, 2006

Canadian applicationsCanadian applications

Seems there is interest across Seems there is interest across Canada in “safe” apology laws.Canada in “safe” apology laws.

Two Canadian provinces have such Two Canadian provinces have such laws. laws.

29 American states have laws 29 American states have laws “protecting” apologies or disallowing “protecting” apologies or disallowing their use in civil proceeding for their use in civil proceeding for medical professionals. medical professionals.

Australia has similar apology laws.Australia has similar apology laws.

QuotablesQuotables

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

- President, South Carolina Trial - President, South Carolina Trial Lawyers Assoc. Lawyers Assoc.

Another quotable…Another quotable…

““No case will be settled until all billable No case will be settled until all billable hours have been achieved by the hours have been achieved by the defense attorney.”defense attorney.”

Risk Manager from an Risk Manager from an

American Hospital American Hospital

So do you need a law to apologize So do you need a law to apologize in Canada or the United States?in Canada or the United States?

Short answer: “No”Short answer: “No” Apology when done right will never Apology when done right will never

hurt you in court or elsewhere hurt you in court or elsewhere Apology laws are great PR tools but Apology laws are great PR tools but

have little legal valuehave little legal value How can we say this?How can we say this?

Important questions no one asks! Important questions no one asks!

What causes customers/taxpayers to What causes customers/taxpayers to want to file a lawsuit?want to file a lawsuit?

What makes juries and judges side What makes juries and judges side with a plaintiff and provide a large with a plaintiff and provide a large verdict?verdict?

Answer: ANGER, not greed. Answer: ANGER, not greed.

22ndnd important question not asked important question not asked

What motivates a plaintiff’s attorney?What motivates a plaintiff’s attorney? An error or mistake is a start, but usually An error or mistake is a start, but usually

not enough to make a case in court. not enough to make a case in court. PI attorneys also want to see a cover-up, PI attorneys also want to see a cover-up,

poor customer service, etc.poor customer service, etc. This is the “plus factor” that This is the “plus factor” that angersangers jurors jurors

and judges and leads to big verdicts. and judges and leads to big verdicts. No plus factor, cases get settled or never No plus factor, cases get settled or never

even filedeven filed

Anger, cover ups, and Anger, cover ups, and poor customer servicepoor customer service

Sorry Works! removes anger from Sorry Works! removes anger from customers/taxpayers.customers/taxpayers.

Sorry Works! alleviates concern of Sorry Works! alleviates concern of cover-up and demonstrates good cover-up and demonstrates good customer service, and will take wind customer service, and will take wind out of cases.out of cases.

To be effective, though…To be effective, though…

Sorry Works! has to be real, Sorry Works! has to be real, meaningful.meaningful.

Four Elements of real apology:Four Elements of real apology:• ““Sorry”Sorry”• Admission of faultAdmission of fault• Explanation of what happened/reformExplanation of what happened/reform• Fair compensationFair compensation

Words of cautionWords of caution

Without the four elements of real apology, Without the four elements of real apology, you you couldcould be in trouble in court: be in trouble in court:• Use “weasel words” like regretUse “weasel words” like regret• Don’t accept responsibilityDon’t accept responsibility• No explanation, no promises of reformNo explanation, no promises of reform• No compensation or effort to make amends.No compensation or effort to make amends.

Increase – not decrease – angerIncrease – not decrease – anger Increase chances of expensive litigationIncrease chances of expensive litigation

To do apology right, we advocate a To do apology right, we advocate a disclosure/apology programdisclosure/apology program

Key leaders in institution or business Key leaders in institution or business trained in how to disclose/apologize.trained in how to disclose/apologize.

Rolled out to entire Rolled out to entire institution/business so everyone institution/business so everyone understands and embraces conceptunderstands and embraces concept

Insurance carrier brought on board Insurance carrier brought on board ahead of time as are defense ahead of time as are defense lawyers. lawyers.

When something bad happens…When something bad happens…

Program snaps to work…Program snaps to work… Injured party approached with Injured party approached with

customer service framework.customer service framework. Sympathize, empathize, and say Sympathize, empathize, and say

“sorry.”“sorry.” Only say what we know.Only say what we know. Begin re-establishing communication Begin re-establishing communication

and trust. and trust.

When something bad happens..When something bad happens..

Do thorough, credible investigation.Do thorough, credible investigation. Share results with injured party and their Share results with injured party and their

attorney.attorney. If you made mistake, say sorry, admit If you made mistake, say sorry, admit

fault, and compensate. fault, and compensate. Compassion.Compassion. If you didn’t make a mistake, say sorry, If you didn’t make a mistake, say sorry,

prove your innocence, but don’t prove your innocence, but don’t compensate and fight any litigation. compensate and fight any litigation. Never settle. Never settle. Backbone. Backbone.

Arar storyArar story

““Apology law would allow PM to say sorry Apology law would allow PM to say sorry to Arar.” (9/28/06, CanWest News Service)to Arar.” (9/28/06, CanWest News Service)

““Prime Minister Stephen Harper issues a Prime Minister Stephen Harper issues a formal apology to Maher Arar while formal apology to Maher Arar while announcing Arar will receive $12.5 million announcing Arar will receive $12.5 million in compensation.” (1/26/07, CBC News). in compensation.” (1/26/07, CBC News).

SummarySummary

Apologies are always “safe” and Apologies are always “safe” and “legally wise” when done right in the “legally wise” when done right in the auspices of a program.auspices of a program.

Don’t need law to apologize. Don’t need law to apologize. Sorry Works! is compassion with a Sorry Works! is compassion with a

backbone. backbone. Sorry Works! is good customer Sorry Works! is good customer

service – most important factor! service – most important factor!

Thank you for listeningThank you for listening

For more information visit our For more information visit our website: website: www.sorryworks.netwww.sorryworks.net

Or contact Doug Wojcieszak at 618-Or contact Doug Wojcieszak at 618-559-8168 or 559-8168 or doug@sorryworks.netdoug@sorryworks.net

Share our website – Share our website – www.sorryworks.netwww.sorryworks.net – with friends. – with friends.

Thank you! Thank you!