Today many doctors are willing to discuss their mistakes with colleagues and patients, and a few are even telling their patients, "I’m sorry." A study published in the Journal of Medical Ethics finds that three out of four internists at teaching hospitals would discuss a mistake they had made with a colleague. However, the study suggests that the likelihood of a physician disclosing an error to a patient or an institution depends on the seriousness of the error. If no harm is done to the patient, 77 percent said they would disclose the error; in a case with minor harm, 87 percent would disclose; and 94 percent said they would disclose an error that resulted in major harm.
"Discussing medical errors can be a form of professional learning for doctors. Mistakes should be considered shared commodities and used for all they're worth," says study co-author Lauris Kaldjian, MD, an associate professor of internal medicine at the University of Iowa Carver College of Medicine.
This month CMS began denying Medicare reimbursement for 10 "never events," which means that medical errors may end up more often in court. Traditionally, lawyers have discouraged disclosure and urged defendants to deny an error and let the patient sue. Some physicians and health institutions are moving away from that legal tactic and doing more than just disclosing their mistakes. "Slowly, disclosures and apologies are returning to the dialogue between healthcare providers and their patients," writes Catherine Griswold, RN, MSN, CLNC, in "Sometimes It’s OK to Say 'I'm Sorry'."
While an earnest apology can’t erase an error, it may ease relations with a patient. More than 70 percent of respondents in a study published in the Lancet in June 1994 said their "decision to take legal action was determined not only by the original injury but also by insensitive handling and poor communication after the original incident."
Read more about the appropriate way to disclose medical errors and when you should — and should not — apologize to patients in Outpatient Surgery Magazine's "Medical Malpractice" column.
—Kent Steinriede
