Afferent CEO Ken Malcolmson sits down with veteran medical license defense attorney and author Victoria Soto to discuss her book, World’s Best Doctors: How Good Old-Fashioned Manners Improve Patient Satisfaction and Can Lower Litigation Risk, which explores the role manners play in helping physicians avoid complaints, litigation and improve the care experience.

KM: Why did you decide to write World’s Best Doctors: How Good Old-Fashioned Manners Improve Patient Satisfaction and Can Lower Litigation Risk?

VS: I’ve been an attorney now for over 20 years. The majority of my practice has been defending physicians before their licensing agencies and consulting with them, physician groups and hospitals regarding any healthcare practice issues they may have.

I wrote this book hoping that doctors and anyone or any healthcare entity or institution could use it as a tool. If I can use the experience that I have gained by working with, literally some of the best doctors in the world, to provide some common sense guidelines and steps and could relay this in stories that could help doctors become more aware of their manners and how important they are in medicine, maybe it can help them avoid getting in trouble.

But more importantly, maybe it could improve their lives and career in medicine and ultimately improve patient’s care in this world.

KM: So why are manners so important when it comes to litigation?

VS: I have found that many times – even though the majority of the cases I work on are cases that deal with standard of care issues – I have found that these wonderful physicians are not at fault, and they have not violated the standard of care.  Please keep in mind that the realization of their innocence may come only after they have endured inquiries, peer reviews, investigations, and sometimes on the heels of serious litigation and/or the loss of their privileges and/or certifications.

So if there is no violation of the standard of care, we have to ask, ‘why was a complaint or lawsuit filed against them?’

Well, when we peel back the layers of the onion, we find the doctor may have wittingly or unwittingly offended someone because of their action or inaction. Many times it’s not about medicine. It’s about the relationship and attitude.

KM: In World’s Best Doctors, you write, “A lot of doctors don’t seem to realize that the difference between having a complaint filed against their licenses and not having one filed often has nothing to do with how well they’ve practiced their craft. Often, it is simply how they’ve acted as human beings in a particular situation.” What do you mean by acting as a human being?

VS: Being a human being is just being able to relate to your patient. Just seeing your patient as an individual – a living, breathing individual that God has blessed you with the ability to serve as their physician, as their caretaker, as their treater, as their healer. They are not their “condition” or “disease”.

We respect people in society that have positions and stature who might have a job that gives them a title, like physician/doctor/attorney/judge, titles of that nature. Doctors have been around since the beginning of our ability to record anything. So the respect for doctors is immense.

Good doctors, I find, are humbled by the title of ‘doctor.’ Good doctors treasure the gift that God has blessed them with – of healing and caring for their patients. They are humbled and accept their calling and vocation of being medical doctors and greatly appreciate the privilege that they have been given in practicing medicine.

KM: Give me a scenario when a doctor could have avoided hundreds of thousands of dollars in litigation had they did one thing differently.

VS: We’ve seen cases where there were multiple doctors involved in the care of a patient on the very sad occasion when a patient has passed away and there was a possible violation of the standard of care.

Where the actual fault lies – if there was a violation of the standard of care – no one person would know without review. However, in that scenario, the doctor, who did not violate the standard of care, could actually be the one who gets sued. We could find that he was the one doctor, who did not take the time to approach the family and give the family their respects and his condolences. His not paying respect to the patient’s family and poor all around attitude could have been the very reason that his was the name that landed on the lawsuit and/or complaints regarding that patient.

If you are the only physician out of a team of doctors that treated that patient who happens to go “missing in action” after that patient has passed on, who do you think the family will notice missing and possibly blame?  Who do you think the family may have some angst for when they realize: ‘Oh Dr. X was so sweet.  He came over and he said how he was so sorry that our mom passed away.  Dr. Y was so kind.  He talked about how he and mom talked of her grand babies prior to the surgery, and how she wanted to bounce them on her knee that was getting replaced after a successful surgery, and how he’s so sorry that our mom is gone.’

Have the good manners to say that you’re sorry for someone’s loss. Show compassion. Show respect. It’s the right thing to do. It’s good medicine.

In part 2 of The Afferent Interview with Victoria Soto, she discusses how manners are impacting physicians’ bottom line now more than ever, patient perspectives on the care experience and how to address a lack of good bedside manner with colleagues.

(Learn more about Victoria’s book here: World’s Best Doctors: How Good Old-Fashioned Manners Improve Patient Satisfaction and Can Lower Litigation Risk)