The theme of The Challenge Dividend is that "challenge leads to improvement". While usually this focuses on the challenging contest itself and celebrating the winners or mocking the losers, I always try to come back to the real winners: everyday consumers and the world itself. I truly believe that the more challenges our businesses and organizations encounter, the better life will be for all of society. A "better life" can mean things like lower prices and better laundry detergent, but I also believe it can touch the spirit and decorum of society itself. One recent example is an article I read several months ago about malpractice rates.
As everyone knows malpractice is a huge issue for patients, doctors and hospitals. "Malpractice" of course, means issues related to a doctor's error, and these errors (whether real or perceived) are costing our country a great deal of money and suffering. Patients feel the pain, as do all doctors, who in some cases have seen their insurance premiums rise 50% due to others' mistakes. Insurers are just passing on their pain; the St. Paul Companies wrote off nearly $1 billion in losses due to malpractice claims against its policy holders. This caused St. Paul to exit the market altogether. Politicians are rousing votes by fighting insurance company premium hikes and aiming to limit the awards of juries.
But while gloom and doom prevail, a little-cited study from 2003 found one critical driver of reduced malpractice suits: nicer doctors. Researchers from Vanderbilt performed a six-year study in which they looked at complaints against 645 physicians. They found that less than 10% of the physicians generated over half of patient complaints, while there were zero complaints against 37% of physicians. Only 8% generated over half of actual malpractice suits. These doctors tended to be busy, male surgeons who spent less time with patients and were less sensitive. A follow-up study with 900 maternity patients found that doctors with high complaint and malpractice claim rates were characterized as rude, uncaring and inattentive, and they even failed to return phone calls.
If you don't believe the data, take if from a malpractice attorney that has sued hundreds of doctors. Boston attorney Alice Burkin has been representing patients for 20 years. According to Burkin:
"The most important factor in many cases—besides the injury itself—is the quality of the patient's relationship with the doctor. People just don't sue doctors they really like. We've had people come in saying they want to sue some specialist, and we'll say, 'We don't think that doctor was negligent. We think it's your primary care doctor who's at fault.' And the client will say, 'I don't care what she did. I love her, and I'm not suing her.'"
While the data may not be lock-solid proof, this is one of those insights that clearly leads to an "a-ha!" Everyone has experienced the pain and concern around seeing a doctor for our own condition or for that of a close family member. The bottom line is that this is a deeply personal and stressful time. We are humans at our most base level. And when a friendly doctor come in, we become like children and give ourselves over to her advice. But a busy or arrogant doctor sends a nasty impression he makes us feel unimportant when our psyches are exposed. This leads to the deep human emotion of anger. At the end of the day, if something goes wrong, most people will either accept it or fight it just based on how good (and nice) the physician was at the time.
Overall, the challenge of patient activism and malpractice lawsuits is forcing physicians to improve their service. One key result is nicer and more comforting physicians; these are people who can treat the body as well as the mind. Those who fail to heal both are more likely to be sued or won't find future employment or insurance coverage. Even better, becoming a better phyisican in this case does not entail more schooling or million-dollar MRI machines; it just means holding someone's hand, smiling, and returning phone calls.
Society might ultimately benefit from lower costs through fewer lawsuits, but the big improvement end result may be a society that is kinder and gentler.
Final note: The idea that society is becoming "nicer" as a result of hard-nosed capitalism and medical lawsuits is furthered by experience in the business world. Here, research continues to show that "people quit their bosses" rather than their companies. In our modern economy, the job market is tight and decision-making power is being driven down to lower ranks versus remaining command and control. So the cost of lost valuable employees is increasing. Companies increasingly are working to weed out jerks and train their managers to be better coaches, listeners, and, well, people!
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