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Mediation saves time and money in medical liability cases, study says

Mediation can help mitigate the costs -- both emotional and financial -- of medical liability lawsuits, according to a recent study. But without participation from physicians -- not just their lawyers -- other quality improvement benefits that can come from the litigation alternative get lost. "It seems pretty clear from the data that there is an economic case ... to support the notion mediation is a more efficient, cost-effective process," said Carol B. Liebman, a professor at Columbia Law School in New York. She co-wrote the report published in the October Journal of Health Politics, Policy and Law (www.ncbi.nlm.nih.gov/pubmed/21123671/). "Our disappointment and surprise was hospitals and physicians are not using mediation in a way to help improve patient safety." The study analyzed 31 cases referred for mediation by various hospital organizations in New York City from 2006 to 2007. The voluntary process uses an impartial outside mediator to help resolve medical liability lawsuits out of court, though parties retain the option to litigate, and any information shared remains confidential. Overall, the various participants in the mediations, including patients, plaintiffs, defense lawyers, and hospital and insurance representatives, said they were satisfied with the proceedings, with 71% of the cases settling. Mediation was shown to save time and ULTIMATEly expenses for both parties involved, while compensating injured patients more quickly. Settlements ranged from $35,000 to $1.7 million, with an average amount of $250,000. On average, the mediations took 3.7 hours, with most attorneys spending about six hours to prepare. Those figures stand in contrast to the 100 hours -- or several days -- lawyers reported would be required for trial preparation. Missed opportunities However, opportunities for improving physician-patient communication and learning from medical errors were missed when not a single physician attended the mediation proceedings, researchers said. Twenty-five of the 31 mediations were attended by plaintiffs, some of whom, when interviewed, cited communication breakdowns before litigating. "Certainly, if you do not have medical professionals at the table, any information you discover from the patient about what went wrong and whether what went wrong was a medical error, is not going to be in the hands of people who can go back to the institution and make changes," Liebman said. Some defense lawyers cited doctors' work schedules as an obstacle to their participation, while others expressed a desire to protect their clients from being subjected to potential verbal attacks. The physicians were not interviewed. A hospital or insurer representative was present in 20 cases. In five of the lawsuits, an apology was offered to the patient. In four cases, hospital representatives who participated said they gleaned information from the proceedings that could lead to better practices. Absent the key players, and left largely to lawyers, mediation becomes more about money than about medical care, Liebman said. Although there is value in fairly compensating injured patients, "hospitals are beginning to recognize there is a lot more going on than just trying to win a case, and mediation presents an opportunity for a whole range of things, from reconciliation to gathering information to restoring reputations," she said. "That is very powerful and very important to the patient safety piece." The full and original article can be found at: http://www.ama-assn.org/amednews/2011/01/10/prsc0112.htm
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