Should a Doctor Apologize?

Physician's Money Digest, May 31 2003, Volume 10, Issue 10

The Journal of the American MedicalAssociation

Medical errors happen, although experts don'tagree on how often they occur. What surveysdo show, however, is that the majority of patientswho are victims of a medical mistake are never toldabout it. A study published a decade ago revealedthat 76% of the physicians who responded had notfully disclosed a serious error to one of theirpatients. Another study, in the February 26, 2003,issue of , showed that patients want to be fullyinformed when errors happen, and believe such disclosurewould build trust in their doctor.

"Doctors should realize that there is a gap betweenwhat they tell patients after a medical error, and theinformation and emotional support that a patientexpects from the doctor," said Dr. Thomas Gallagher,lead author and assistant professor of medicine at theUniversity of Washington, Seattle.

Fear of malpractice suits is the reason most oftengiven for why physicians are less than candid withtheir patients, but some experts also detect a dichotomybetween how physicians and patients define amedical error. Patients tend to include adverse outcomesand poor interpersonal skills under the medicalerror umbrella, while doctors have a stricter interpretation,limiting the definition of a medical mistake toa clear departure from accepted standards ofcare. Both patients and physicians believe that anapology is okay in principle, but for many physicians,the malpractice monster looms large. Manyfear that apologizing could be taken as an admissionof legal liability for the error.