Last week, Medscape shared a five-part story that analyzed doctor perceptions about apologizing to patients following a medical error. Does apologizing to a patient lead to less conflict and better outcomes than staying silent?
The main tension is between potential legal liability and a desire to be honest with patients. On one hand, doctors may be tempted to act on their natural human instinct and say “I’m sorry” when a mistake was made. However, there is concern that the apology itself may be used as evidence that malpractice was committed in a legal action that may stem from the incident.
To combat the fear, a majority of states, including Illinois, have passed “apology laws” which generally do not allow doctor apologies to be admitted as evidence in a future malpractice case. One of the leaders of the movement to pass such laws run a company called “Sorry Works! LLC.” The man lost his own brother from malpractice and his family filed suit. He noted that his motivation in bringing the lawsuit was not money–they wanted accountability and acknowledgment.
The Medscape article, which includes analysis of a doctor survey on the subject, suggests that medical professionals are largely dismissive of the apology benefit. A majority of doctors responded that they felt apologies were useless.
One of the minority who supported the use of being open and honest with patients explained in the following manner: “It’s a mistake to say that an apology is a bulletproof vest against the guns of malpractice suits. But it’s also a mistake to say that it doesn’t work or makes things worse. Everything depends on the timing, the situation, the state you live in, and how you go about apologizing.”
It is perhaps not surprising that many doctors are disillusioned about apologies. This mirrors recent studies which found that doctors drastically overestimated their risk of facing a malpractice lawsuit. Perceptions of those in the medical professionals related to legal matters are consistently skewed.
The Form Matters
The Medscape article shares some interesting thoughts from an apology-proponent which suggests that the way in which the apology is given has an effect on its value.
It is important for the medical professional to remain in contact with the family throughout the process, from the immediate aftermath to the review process. Coming in only later with a brief apology will not have any effect, as it is sign of neglectful empathy. As one advocate summarized for doctors, “Let logic and compassion inform your decision.”
No two malpractice cases are identical. At the end of the day, everyone is best served with openness, honesty, and accountability. When a doctor in Illinois makes a mistake that causes harm, the matter can be resolved in a fair way only if both sides are clear about their perspective and willing to do whatever necessary to provide redress. There is nothing about the process that requires ignoring basic values and fair human interactions.
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