The Tort Reform Solution – Patient Interactive Reporting

In his speech this week the President agreed to explore solutions to the tort reform issue. P-IR presents a solution that is aligned with the goals of transparency, patient centered care and lower costs, and should be among the first solutions researched.

Wait, aren’t patients the ones that sue doctors in the first place?

They are, but why? Well first, because sometimes doctors, because they’re human, make mistakes which do serious harm to their patients. These are the legitimate suits. We can argue forever over whether or not awards should be capped, but that’s not the real problem. The real problem is what is called “defensive medicine”. The second reason doctors get sued is that their patients feel disconnected from them. Study after study shows if the patient likes the doctor, feels connected to the doctor, the same outcome, even negative, is much less likely to lead to a law suit. Recently it’s been demonstrated that a simple apology sometimes works to avoid litigation.

Patient Interactive Reporting (P-IR) is the Fix.

If there was a real time electronic record of the key aspects of each clinical visit, reported by the patient and collected by an unbiased third party, doctors could feel safe in practicing far less defensive medicine. Defensive medicine is practiced to create a record. Doctor’s legitimately fear that no matter how well intentioned, safe and reasoned there treatment is, if something goes wrong and they haven’t done everything, even if everything wasn’t really necessary, they are at a disadvantage when they get sued. This is a very, very expensive way to practice – expensive for everyone –and can even be used as a cover for the simple over utilization that is rewarded under current billing models.

Imagine a patient that tragically loses a foot to diabetes. Someone says, “You should sue.” Comes time for deposition and the patient says they never really discussed foot care, “He would look at my feet, sometimes, but I never knew why. “ This can, and does happen, even if the notes indicate foot care was discussed. If there is a patient generated record from each visit that indicates the doctor did discuss foot care with the patient most legitimate medical malpractice lawyers would simply give the client back his records after review knowing he has no case.

In addition to creating an unbiased record, P-IR allows for the inevitable oversights that occur in a rushed office to be corrected in real time. If the patient reports that the doctor did not discuss his hemoglobin a1c level with him, an immediate alert can be emailed to a designated person within the office and that issue can be addressed before the patient leaves the office or immediately after. Implementation of P-IR in the office should qualify the physician for a reduction in malpratice premiums.

Dignified Accountability

Lastly, by hardwiring the patient directly into his care team, P-IR creates a real therapeutic partnership between the patient and his caregivers. By engaging and empowering the patient the doctor has hardwired a strong relationship with that patient into the process that prevents the kind of sterile, detached interaction that leads to law suits. The patient is given dignified accountability for his care which leads to sharing in the responsibility for the outcomes, both good and bad.

P-IR represents a transparent, systemic, hardwired solution to the communication issues that lead to the gross overutilization caused by the practice of defensive medicine, disengaged patients and a culture of litigation.