The Medical Malpractice Analogy, or, a Question of Trust

I recently heard a presentation about the importance of trust in the school district-parent relationship, especially when it involves a child receiving special education services.  Parents of kids with special needs are relying on the school to provide the services set forth in the child's IEP, and to provide their child with FAPE (a fair and appropriate public education).  If the system breaks down - the child isn't receiving the specified type, or amount, of services; the school isn't implementing the specified accommodations or behavior plan; the child is being "taught" by an unskilled aide in a trailer on the edge of campus (no really) - then that trust between the school and the parent is destroyed.  Even if the situation is resolved through an IEP meeting, or mediation or other dispute resolution process, how can the parents trust the school again?

The dynamic has permanently changed.  This particular parent, who may have been easygoing before, is going to be more demanding, more insistent on record keeping, and less trustful.  How can the school rebuild the trust?



Well, at this presentation I went to, the speaker had an interesting model to consider.  He analogized the school-parent relationship to the medical doctor-patient relationship, especially in regards to malpractice claims. 

A study of malpractice litigation (published in the Journal of the American Medical Association in 1997 - I can get you the cite if you want) revealed that the actual level of medical care is not determinative of the rates of malpractice suits; while quality of care is certainly a trigger, it's not dispositive.  What is dispositive is patient dissatisfaction.  And patient dissatisfaction, in turn, is triggered by the patient feeling like the doctor didn't listen and didn't care.  Good communication, on the other hand - active listening, using humor to connect, spending the time that the patient seems to need - leads to trust, and patient satisfaction.

When patients feel like they can sit down and discuss concerns with their doctor, they are simply less likely to hire a lawyer.  Makes sense, right? 

I think this is a pretty good analogy to the special education process, and the importance of good communication between the parent and the school.  If the parent feels like school personnel are listening, accessible, and collaborative, that's contributing to a bank of goodwill.  If, then, some issue arises in the future, the school will be able to draw upon that past history of goodwill, and maybe, just maybe, the dispute can be resolved quickly and at low-cost. And that's good for everyone - especially the student.