All you need to read in the other general journalsBMJ 2010; 341 doi: http://dx.doi.org/10.1136/bmj.c4619 (Published 25 August 2010) Cite this as: BMJ 2010;341:c4619
It pays to handle medical errors ethically
In 2001, the University of Michigan Health System changed how it dealt with patients’ claims for compensation. Instead of the old practice—where a claims management committee reviewed the case and recommended settling or going to trial—the new practice meant that all claims underwent an internal inquiry. If a medical error was identified then fault was admitted and compensation offered; if no error was found, the claim was rejected, arguments presented, and the stand vigorously defended⇑.
This is in line with medical ethics and the principles of patient safety, but the practice is far from widespread. Only one centre had previously reported data on claims and costs after a similar procedure was implemented. Despite a drop in malpractice payments seen with that programme, the centre mostly served US military veterans and it was unclear whether the findings could be extended beyond that population. The Michigan experience shows that they might.
A total of 1131 claims were recorded during the 12 year study, 633 before the new programme was implemented and 498 after. Average monthly figures per 100 000 patients decreased in the second period for new claims (from 7.03 to 4.52) and lawsuits (2.13 to 0.75). Median time to resolution decreased from 1.36 years to just under a year, and the average cost per lawsuit decreased from $405 921 (£261 454; €319 825) before implementation to $228 308 after.
The findings might in part be the result of a change in state legislation aimed at controlling malpractice, which was introduced seven years before the study began.
Tai chi is better for fibromyalgia than education plus stretching
Tai chi is a mind-body practice that originated in China as a martial art and has been described as a complex, multicomponent intervention that integrates physical, psychosocial, emotional, spiritual, and behavioural elements. In a trial of 66 people with fibromyalgia, tai chi was delivered in two hour long …
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