의료분쟁과 화해: 체계적인 의사소통과정을 통한 자율적 분쟁처리

This paper examines the relationship between poor physician-patient communication and litigation. The most important factor leading to a compromise in a medical dispute following an adverse event is a match between what the patient wants and what the physician provides. The following recommendations, based on the pew demonstration mediation and ADR project in Pensylvania hospitals, are given: 1) that physicians and other health care professionals develop an awareness of the communications skills most likely to be useful during disclosure conversations; 2) that hospitals recruit or train in-house experts available as consultants to aid in planning, conducting, and debriefing disclosure conversations; 3) that hospitals encourage physicians, patient safety officers, and risk managers to spend time planning before conducting disclosure conversations; 4) that physicians, hospital representatives, and other health care providers offer an appropriate apology after an adverse event or error; 5) that hospitals and senior physicians provide opportunities for debriefing and support for health care professionals after an error; 6) that hospitals use mediation as soon as practical after an adverse event to settle potential claims. Taking steps to improve disclosure conversations and using alternatives to litigating medical malpractice claims will help hospitals reduce costs, improve patient safety, and restore trust.