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How Disclosing Medical Errors Reduced Malpractice Claims

Author: University of Michigan Health System
Published: 2010/08/17 - Updated: 2026/02/22
Publication Type: Findings
Category Topic: Medical - Related Publications

Contents: Synopsis - Introduction - Main - Insights, Updates

Synopsis: This research covers a peer-reviewed study published in Annals of Internal Medicine examining how the University of Michigan Health System's policy of fully disclosing medical errors and proactively offering compensation affected malpractice claims and liability costs over a 12-year period from 1995 to 2007. Led by Allen Kachalia, M.D., J.D., Medical Director of Quality and Safety at Brigham and Women's Hospital - a Harvard Medical School teaching affiliate - and co-authored by Richard C. Boothman, chief risk officer at the University of Michigan, the study found that open disclosure resulted in fewer new claims, a 61 percent decrease in legal defense spending, and faster claim resolution times. Funded by the Blue Cross Blue Shield of Michigan Foundation, the research carries significant institutional and academic weight. For patients, disability advocates and healthcare professionals, this study is particularly relevant because it provides evidence that transparency after medical mistakes not only serves patients ethically but also improves safety culture and does not lead to the increase in litigation costs that hospitals have long feared - Disabled World (DW).

Topic Definition: Medical Error Disclosure

Medical error disclosure is the practice of proactively informing patients and their families when a preventable mistake has occurred during their care, rather than concealing the error or waiting for the patient to discover it independently. In a full disclosure model, such as the one implemented by the University of Michigan Health System beginning in 2001, hospitals not only acknowledge the mistake but also investigate its cause, offer compensation when the institution is at fault, and use the findings to improve patient safety systems. This approach stands in contrast to the traditional defensive posture adopted by most healthcare institutions, where errors were often handled through legal channels with minimal communication to the affected patient, driven by concerns that transparency would increase malpractice litigation and financial liability.

Introduction

Disclosure of Medical Errors Decreased Claims

U-M's efforts to encourage disclosure of medical errors decreased claims - Admitting mistakes did not lead to more malpractice costs.

The University of Michigan's program of full disclosure and compensation for medical errors resulted in a decrease in new claims for compensation (including lawsuits), time to claim resolution and lower liability costs, according to a study published Aug. 17 in the Annals of Internal Medicine.

"The need for full disclosure of harmful medical errors is driven by both ethics and patient safety concerns," said lead study author, Allen Kachalia, M.D., J.D., Medical Director of Quality and Safety at Brigham and Women's Hospital. "However, because of fears that disclosing every medical error may lead to more malpractice claims and costs, disclosure may not happen as often and consistently as we would hope."

Main Content

In 2001, the University of Michigan Health System launched a comprehensive claims management program that centered on full disclosure with offers of compensation for medical errors. Under this model, U-M proactively looked for medical errors, fully disclosed found errors to patients and offered compensation when at fault. Researchers conducted a retrospective before-and-after analysis to determine how the UMHS model affected claims and costs. Reviewing claims from 1995 to 2007, researchers found a decrease in new legal claims (including the number of lawsuits per month), time to claim resolution, and total liability costs after implementation of the disclosure with offer program.

"The decrease in claims and costs may be attributed to a number or combination of factors," says Kachalia. "We found a 61 percent decrease in spending at the UMHS on legal defense costs, and this supports the possibility that patients may be less likely to file lawsuits when given prompt transparency and an offer of compensation."

Researchers hope that this study will alleviate the fears associated with disclosure and will further encourage efforts to disclose all harmful medical errors.

Richard C. Boothman, chief risk officer at the University of Michigan and a co-author of the study, says the research proves that a policy of fully disclosing errors does not appear lead to skyrocketing medical costs.

"This shows that over time, hospitals can afford to do the right thing," Boothman says. "It demonstrates what we have believed to be true for some time: the sky won't fall in by pursuing a pro-active and honest approach to medical mistakes."

But Boothman adds that reducing costs is not the main motivation behind the U-M policy. Changing the culture to encourage caregivers to admit mistakes also has improved patient safety, which is much more difficult to measure, he says.

"We cannot improve if we're not honest about mistakes. By engaging the patient early "and mostly listening more than talking at first "we get a fuller view of what happened, a better view of what it looked like to the patient, facts that may not be apparent from the chart alone. Engaging patients and families early even before we have reached our own conclusions allows us to get a more accurate view of what happened and provides the opportunity to correct any mis-impressions and misunderstandings for everyone concerned," says Boothman.

"We are all in this together. We support our staff best by being honest about mistakes because without that honesty, we'll never fix the problem, other patients may get hurt and we'll expose our staff to that heartbreak again, too. Honesty is the key to improving and hurting no one else is the best risk management I can imagine."

Additional Authors

Samuel R. Kaufman, M.A., Susan Anderson, M.B.A., M.S.N., Kathleen Welch, M.S., M.P.H., Sanjay Saint, M.D., M.P.H. and Mary A.M. Rogers, Ph.D, M.S.

Funding

Blue Cross Blue Shield of Michigan Foundation.

University of Michigan Health System

The University of Michigan Health System includes the U-M Hospitals & Health Centers, which comprises three hospitals and dozens of outpatient health centers and clinics; the U-M Medical School with its Faculty Group Practice and extensive research and education programs; the clinical operations of the U-M School of Nursing; and the Michigan Health Corp. The three U-M hospitals are University Hospital, C.S. Mott Children's Hospital, and Von Voigtlander Women's Hospital. UMHS has been recognized numerous times for excellence in patient care, including 15 years on the honor roll of "America's Best Hospitals", as compiled by U.S. News & World Report.

Insights, Analysis, and Developments

Editorial Note: The conventional wisdom in healthcare for decades was that admitting a medical error would open the floodgates to litigation, and that instinct to stay quiet shaped how hospitals handled mistakes in ways that ultimately harmed both patients and the institutions themselves. What the University of Michigan proved through more than a decade of data is that the opposite is true - honesty reduced lawsuits, cut legal costs by 61 percent and, perhaps most importantly, created conditions where the actual causes of errors could be identified and addressed before they hurt someone else. Richard Boothman's observation that engaging patients early and listening before speaking gives hospitals a fuller and more accurate picture of what went wrong gets at something fundamental about trust in medical care. For people with disabilities, seniors and anyone who depends on the healthcare system at its most vulnerable moments, the takeaway from this study matters deeply - because a hospital willing to own its mistakes is also a hospital far more likely to prevent the next one - Disabled World (DW).

Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by University of Michigan Health System and published on 2010/08/17, this content may have been edited for style, clarity, or brevity.

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APA: University of Michigan Health System. (2010, August 17 - Last revised: 2026, February 22). How Disclosing Medical Errors Reduced Malpractice Claims. Disabled World (DW). Retrieved April 17, 2026 from www.disabled-world.com/medical/medical-error-claims.php
MLA: University of Michigan Health System. "How Disclosing Medical Errors Reduced Malpractice Claims." Disabled World (DW), 17 Aug. 2010, revised 22 Feb. 2026. Web. 17 Apr. 2026. <www.disabled-world.com/medical/medical-error-claims.php>.
Chicago: University of Michigan Health System. "How Disclosing Medical Errors Reduced Malpractice Claims." Disabled World (DW). Last modified February 22, 2026. www.disabled-world.com/medical/medical-error-claims.php.

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