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Gregoire nails down malpractice reform

OLYMPIA – After weeks of closed-door meetings with groups that were at one another’s throats for much of last year, Gov. Chris Gregoire has brokered a deal for a slew of patient safety and medical malpractice reforms. Among them: protecting whistle-blowers, creating an arbitration system, and making it easier for doctors to say they’re sorry.

“No one got everything they wanted, myself included,” Gregoire said Monday. “But that’s the nature of negotiation, the nature of compromise.”

The deal caps last year’s $14 million battle among doctors, lawyers and insurers over two competing initiatives to reform malpractice laws. After the state’s most expensive ballot measure battle, with ads portraying lying lawyers and deadly doctors, voters killed both proposals.

Gregoire, who in December had called for a “cooling off period” after the fighting, decided to try to work out a deal. On Monday, a political triad that would have been unthinkable last year – hospitals, trial lawyers and the state medical association – sat side by side in an Olympia hearing room and endorsed Senate Bill 2292.

“The governor … has actually shown us the high art form of compromise,” said bill sponsor Rep. Pat Lantz, D-Gig Harbor.

Despite the deal, all sides say that more changes are needed in the future.

“This (bill) was a big bite of the apple,” Insurance Commissioner Mike Kreidler said. “There are other bites to be taken.”

A top priority for both Gregoire and doctors is the bill’s change in the legal admissibility of apologies. Under the compromise, health providers’ statements of fault, sympathy or apologies would not be admissible in court unless made on the eve of a lawsuit.

“It will bring some humanity back to care of the patient at the hospital,” said Dr. Peter Dunbar, an anesthesiologist who is president of the Washington State Medical Association.

“In the most contentious of tort lawsuits, the lawyers would sit and talk to each other about settling the case when suddenly you’d have a family member who’d speak up and say, ‘All I want is for someone to say they’re sorry,’ ” said Gregoire, who was the state attorney general for 12 years. When someone loses a loved one, she said, “they want to know, if a mistake’s been made, that someone will say, ‘I share your pain and I want you to know how sorry I am that this happened.’ “

Doctors in Idaho are seeking the same thing. The Idaho Medical Association is calling for legal changes to allow health care providers to apologize when things go wrong without the risk of that apology later being used against them in court.

“It’s not going to stop lawsuits,” association spokesman Bob Seehusen told the Associated Press in Boise, “but it may minimize some of those that can be dealt with by explanation and conversation and communication.”

The Washington bill includes many other reforms. Among them:

“Health professionals who report problems or testify against another health professional about bad conduct or physical or mental problems would be immune from lawsuits for damages.

“A new “voluntary arbitration” system would be set up to resolve disputes costing less than $1 million.

“For the most serious violations, the state would permanently yank the medical license of a health provider after three sanctions by state health regulators.

“Hospitals and other medical facilities must report any “adverse events,” such as unanticipated deaths, suicides, infant abductions, rapes, incorrect blood transfusions, fires, or surgeries on the wrong person or wrong body part. Patients would also have to get written notification.

“Insurers would have to report any closed claims to the state, including litigation costs, doctors and any settlement. The data would be secret from the public but would be combined to create public data on the true costs of malpractice cases.

“It means that we won’t be making arguments over anecdotes any longer,” Kreidler said.

“The bill also sets requirements for expert witnesses, which would usually be limited to two per side.

On Monday, the doctors’, lawyers’ and hospital groups all praised Gregoire for brokering the breakthrough. Sen. Alex Deccio, R-Yakima, joked that the governor deserved a medal of valor.

Sen. Adam Kline, D-Seattle, had a similar take on the surprise compromise.

“I believe it was Prime Minister (Yitzhak) Rabin of Israel who said that peace is not made by talking to your friends,” he said.



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