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If bad “bedside manner” is correlated with malpractice suits, then this policy is a rational response to that. It’s the same line of thinking that motivates insurance companies to charge higher premiums to people with poor credit. So it sounds like a smart insurer policy.

Incidentally, many lawsuits are brought simply when one person makes a mistake and will not apologize for or acknowledge that mistake. The multi-million-dollar Karen Silkwood verdict resulted only after Kerr-McGee refused to pay for Ms. Silkwood’s funeral. Not everyone is a money-grubbing potential plaintiff. Many seek legal counsel after a defendant’s indignation. “How *dare* you suggest *I* did anything wrong.” “Fine. We’ll see you in court,” is how many respond.

People tend to be forgiving, so there is much to be said for graciousness. If these doctors have such off-putting personalities that they are uninsurable, then that’s something they should work on. Someone will likely say, “Bah! They should focus on being doctors!” However, the practice of medicine is a service that involves extensive human interaction. People skills are part of the job description – this is the case whether or not malpractice verdicts are at issue. So being a decent person often goes hand-in-hand with being a good doctor.

It’s funny, I thought providing quality medical care was indicative of a good doctor.

Bedside manner is part of being an effective doctor. The doctor has to listen to the patient or is likely to miss important information for a diagnosis. The doctor has to talk to the patient and family to explain treatment options, and give instructions for the use of drugs or pre-operative and post-operative care. And the doctor has to instill a certain sense of confidence in patients, or he’ll see them abandoning generally-accepted medicine for quack diets, etc…

Now, whether the insurance company’s tests and counseling are any good for measuring and improving those qualities is another question – but if they can measure them, they should.

Mike,

You make several good points, however, your scond paragraph is entirely wrong-headed.

While it’s true that some people would not sue if given an apology, those who DO sue can (and often do) get a LOT more money, because the doctor just admitted A) something bad happened, and B) it was the doctor’s fault.

Heh.

A test based on the “House” TV show.

Mike’s right that this is a rational response; it is, however, a rational response to irrational conditions. Of course better bedside manner will result in more favorable patient opinions; the problem is that unfavorable patient opinions translate into far more $xx million suits than they should.

And the first request from the plaintiff’s lawyer will be for the doctor’s test scores and counseling records. This is going to play well at the trial.

Mike, people tend to be forgiving, but their lawyers like to point to their expressions of regret, sorrow, or dismay as admissions of fault. And, since it is never about the money, such fault can only be redressed with seven figure numbers.

From the insurance co point of view it’s all about risk exposure. It’s irrelevant that quality medical care is provided if there is some other factor also correlated with risk. Actuaries can’t quantify “quality of care” quite as easily as they can the scores on a personality test.

FWIW, An interesting discussion of the relationship between a doc’s bedside manner and his (or hers etc) chances of being sued was in Gladwell’s “Blink” bestseller. Here it is, as best as I recall it:

Docs were rated on bedside manner in various ways. Yup, the arrogant ones (as rated by observers) were sued the most.

Even more interesting, tapes were played of the docs in conversation w/with their patients, with the audio fuzzed so that tone of voice, but not the words, could be made out.

Same results. Likeable docs were simply not getting sued, even if that meant that the patient had to sue someone more farfetched instead.

In the words of one malpractice lawyer, her clients simply refused to sue a doc that they liked.

We know docs are good test takers.

Any doc with a bad score on this test? Stoned, not disruptive.

I would hope that this personality test goes further than manners. I know a doctor or two whose psychoses confine them to the lab and well outof the patient’s way.

“And, since it is never about the money, such fault can only be redressed with seven figure numbers.”

That’s simply not true… there are also 8-digit and 9-digit numbers that can redress the fault as well.

And Bumper scores it right, of course.

Seems there’s a two-digit number that would also do the same thing . . . 11, as in Rule 11.

I recall there is in fact evidence that shows more communicative doctors get fewer malpractice suits.

And think about it, it makes sense. Bad outcomes are inevitable in medicine. Helping a patient though better communication to understand that, and to understand why an outcome was bad results in a more satisfied — even if not cured — patient. And that’s better medicine. This is not a matter of an irrational response to an irrational system. It’s better medicine.