Thomas H. Gallagher M.D.
Professor
Department of Medicine
University of Washington
Email: thomasg@u.washington.edu
Discipline: Medicine, Ethics
Investigator Award 
Responding Justly to Patients Harmed by Medical Care: Disclosure, Compensation, and LitigationAward Year: 2007 The Institute of Medicine's 2000 report, To Err Is Human, and the widespread media attention it received, dramatically increased awareness of the extent of medical mistakes in U.S. hospitals. Since then, a number of states and national quality organizations have adopted policies requiring or encouraging medical professionals to tell patients and families when unanticipated "adverse events" occur. Some organizations and insurers have gone even further by adopting programs through which disclosures of adverse events are accompanied by offers of compensation (known as disclosure and offer or D&O programs). Still, prompt disclosure of medical errors and fair compensation remain the exception rather than the rule. Thomas H. Gallagher, M.D. and Michelle M. Mello, J.D., Ph.D., M.Phil., seek to more fully understand the effects of disclosure initiatives and innovative D&O programs on malpractice costs and patients' access to compensation. Their project, Responding Justly to Patients Harmed by Medical Care: Disclosure, Compensation, and Litigation, explores how policy levers can be used to make disclosing errors more routine and evaluates the design and effectiveness of D&O programs. Their work should help policymakers better understand the potential of these initiatives and how they might best be integrated into broader medical liability reforms.
Background 
Thomas Gallagher, M.D., is a general internist who is professor in the departments of medicine and bioethics and humanities at the University of Washington. Dr. Gallagher has a long-standing research interest in the ethical, communication, and policy dimensions of conflicts of interest, with a primary focus on disclosure of medical errors and adverse events to patients. His empirical research has used both quantitative and qualitative methods to explore patients', physicians', and nurses' attitudes towards the disclosure of harmful errors; how physicians' disclose errors to patients; the impact of simulation training on healthcare workers' team communication and error disclosure knowledge, attitudes, and skills; physicians' attitudes towards reporting adverse events and errors to healthcare organizations, and the emotional impact of errors on physicians. Additional work is exploring the disclosure of other healthcare workers' errors to patients, and strategies for measuring patient and physician assessment of the quality of actual disclosures. Dr. Gallagher received his medical degree from Harvard University, completed his residency in Internal Medicine at Barnes Hospital, Washington University, St. Louis, and undertook a fellowship in the Robert Wood Johnson Clinical Scholars Program, UCSF. He cares for patients in both the outpatient and inpatient settings.
- Murtagh, L., Gallagher, T., Andrew, P., Mello, M. Disclosure-and-Resolution Programs that Include Generous Compensation Offers May Prompt a Complex Patient Response. Health Affairs, Dec 2012, 31(12): 2681-9.
- Brown SD, Lehman CD, Truog RD, Bowning DM, Gallagher TH. Stepping out further from the shadows: Disclosure of harmful radiologic errors to patients. Radiology, 2012;262(2):381-6.
- Dintzis, S.M., Stetsenko, G., Sitlani, C.M., Granowski, A.M., Astion, M., Gallagher, T.H. Communicating Pathology and Laboratory Errors: Anatomic Pathologists. and Laboratory Medical Directors' Attitudes and Experiences. American J of Clinical Pathology
- White, A.A., Bell, S.K., Krauss, M.J., Garbut, J., Dunagan, W.C., Fraser, V., Levinson, W., Larson, E.B., Gallagher, T.H. How Trainees Would Disclose Harmful Medical Errors. Medical Education, Apr 2011, 45(4): 372-80.
- Souter, K., Gallagher, T. The Disclosure of Unanticipated Outcomes of Care and Medical Errors: What Does This Mean for Anethesiologists? Anesthesia & Analgesia, 2011, 114(3): 615-21.
- Bell SK, Delbanco T, Anderson-Shaw L, McDonald TB, Gallagher TH. Accountability for medical error: Moving beyond blame to advocacy. CHEST, 2011;140(2):519-26.
- Mello, M.M., Gallagher, T.H. Malpractice Reform - Opportunities for Leadership by Health Care Institutions and Liability Insurers. NEJM, 2010, 362(15): 1353-6.
- Dudzinski, D.M., Hebert, P.C., Foglia, M.B., Gallagher, T.H. The Disclosure Dilemma--Large-scale Adverse Events. NEJM, Sep 2010, 363(10): 978-86.
- Mastroianni, A.C., Mello, M.M., Sommer, S., Hardy, M., Gallagher, T.H. The Flaws in State 'Apology' and 'Disclosure' Laws Dilute Their Intended Impact on Malpractice Suits. Health Affairs, Sep 2010, 29(9): 1611-9.
- Gallagher, T.H. Clinical Crossroads: A 62 year-old Woman with Skin Cancer who Experienced Wrong Site Surgery: Review of Medical Error. JAMA, 2009, 302(6): 669-77.
- Gallagher, T.H., Cook, A., Brenner, R.J., Carney, P., Miglioretti, D.L., Geller, B.M., Kerlikowske, K., Onega, T., Rosenberg, R., Yankaskas, C., Elmore, J. Disclosing Harmful Mammography Errors to Patients. Radiology, 2009, 253: 443-52.
- Gallagher, T.H., Bell, S.K., Smith, K.M., Mello, M.M., McDonald, T.B. Disclosing Harmful Medical Errors to Patients. Chest, Sep 2009, 136(3): 1-7.
- Dintzis, S.M., Gallagher, T.H. Disclosing Harmful Pathology Errors to Patients. American Journal of Clinical Pathology, 2009, 131(4): 463-5.