Few at the time could argue against the benefits to patients of open disclosure. But in the years since, one question has remained: are these policies also beneficial to physicians, many of whom are already struggling just to get their work done?

According to a study released this week in The Annals of Internal Medicine and the experience of one of the early-adopter institutions, the answer appears to be yes.

Since 2001, the University of Michigan Health System has handled patient injuries by initiating discussions with patients and families, conducting internal investigations and offering apologies with offers of compensation should those investigations reveal medical errors. To examine the repercussions of such an open disclosure with compensation policy, researchers analyzed the number of claims and lawsuits filed against the hospital system between 1995 and 2007, comparing data from before and after the policy took effect.

Contrary to fears that such transparency might worsen litigation, the researchers found that there were actually fewer lawsuits and claims after the hospital began its disclosure with compensation program. Moreover, the hospital system’s liability costs for lawsuits, patient compensation and legal fees dropped, and claims in general were resolved faster than ever before.

“Everybody worries that disclosure will lead to liability going through the roof,” said Dr. Allen Kachalia, lead author and an assistant professor of medicine at Harvard Medical School. “But here’s one institution that set up their disclosure program privately and independently, helped their patients avoid using the courts and tort system, and did not sustain the skyrocketing claims and costs that others might have predicted.”

The disclosure process at Michigan involves a series of meetings that take anywhere from a few weeks to more than a year to complete. Doctors, other involved clinicians and members of the hospital’s risk management department meet with the patient and family members to explain the events, offer assurances that the investigation will be timely and thorough, and promise that all will be done to prevent such a mistake from ever occurring again. While not all of the injuries investigated are due to errors, those that are result in compensation ranging from a simple formal apology to a check, mortgage payments and funding for named lectureships and memorials.

“When you break that paradigm of litigation and give patients the chance to understand the human element of the other side  of the doctor and what they are struggling with  you find that people are far more forgiving and understanding than has been typically assumed,” said Richard C. Boothman, one of the study’s authors and the medical center’s chief risk officer, who devised and carried out the disclosure program. “We have given patients no alternative but to sue, and then we use the fact that they sue to show how opportunistic and awful they are.”