Disclosure, Apology, and an Offer

On April 18, 2012, the Massachusetts Medical Society and an alliance of healthcare organizations announced a major initiative to improve the medical liability system in that state. The Roadmap to Reform ) describes a new approach to improve patient safety, increase transparency, reduce litigation, and cut costs to the healthcare system. The Roadmap proposes a process of disclosure, apology, and offer (referred to as “DA&O”).

With a DA&O model, healthcare professionals, institutions, and their insurers disclose adverse outcomes to patients and their families. They also investigate and determine what happened, establish systems to improve patient safety and prevent the recurrence of these incidents, and when appropriate, apologize and offer financial compensation. These proactive actions are intended to avoid patients resorting to legal action when adverse events occur. Patients may still pursue legal action, but legal action would become a “last resort.” Adverse events in which the provider or institution is deemed to have met the standard of care would be vigorously defended.