Mindfulness in medicine: Communication — or lack of it — at the heart of malpractice

Ronald M. Epstein, M.D., FAAHPM, explains that mindfulness training is directly relevant to medical risk management because greater presence and communication can reduce malpractice exposure, even when clinical errors occur. He notes that analyses of malpractice claims consistently reveal communication failures at their core, which is why insurers incentivize mindfulness workshops as a way to strengthen physician–patient relationships and lower legal risk.

Melissa Lucarelli, M.D., FAAFP: Now I have kind of a confession to make. I first read your book when it was sent to me as a free gift from my malpractice insurance carrier. How do you think your book is relevant to medical risk management, and why did they send that to me?

Ronald M. Epstein, M.D., FAAHPM: Well, I can tell you a couple things. One is that we do workshops for physicians, either anything from half a day to three days, just helping them find ways of being more mindful in clinical practice. And our risk management department has arranged that for anyone taking one of these workshops of three hours or more, they get a 15% discount on their medical malpractice. That could be quite substantial. And the reason they're doing that is, the argument is that if physicians are more present, if they communicate better, even if errors do occur, they're less likely to get sued, and they're less likely to get sued for as much. And there's some good data on looking through malpractice claims. A colleague of mine, Howard Beckman, did that a number of years ago, and embedded in almost all of the complaints is a failure of communication. And so errors happen all the time in medicine, and only a very small part, a small percentage of them, ever end up in court or even with a complaint. And so improving that level of attentiveness, presence, and communication is really foundational.