In a New York Times article on July 15, 2014 which discussed how doctors are loath to apologize for non-preventable errors, Dr. Abigail Zuger noted that, “[i]n health care…apologies are a hot topic, the subject of much research, dozens of new laws and an increasing amount of instruction time for trainees.” Whether regarded as preventable or not, the various reasons for physicians’ reluctance to disclose errors, the advantages to be gained from admitting and discussing those errors with patients when they occur, and the recommended timing and components of an effective disclosure, each merit discussion.
At the outset, it must be underscored that, no matter how focused and careful a physician is in providing care to her patients, or how determined and thorough her efforts may be to prevent medical errors, inevitably they will occur. Therefore, all medical care providers should be prepared in advance to deal with the important decision which then arises, of exactly how and when the patient should be advised of the error. Such will be the subject of a series of blog posts.
But first, it must also be recognized that, although disclosure of medical errors should be encouraged, at times there may be an understandable reluctance on the part of many physicians to disclose those errors, based upon a myriad of legitimate concerns.
First of all, the physician may be concerned about potential damage to her reputation in the community, as likely an admission and discussion of a medical error will be further discussed, at minimum, with the patient’s other medical care providers.
Additionally, all physicians desire at all times to appear professional, capable and in charge in front of the patient. A physician may be concerned that acknowledgement of a medical error may undermine that authority, and cause a loss of patient trust.
Further, the medical care provider may fear potentially initiating or providing a harmful admission for use in a lawsuit.
Finally, the physician may simply seek to avoid an awkward and embarrassing discussion with the patient.
Although the foregoing concerns are among the understandable reasons for at times hesitating to disclose a medical error to a patient, nonetheless the recognized benefits of physicians willingly admitting and discussing errors have become more widely acknowledged during recent years. In fact, those benefits have been recognized by a number of state legislatures. As Dr. Zuger further notes, according to the American Medical Association, all but 14 states have passed laws designed to encourage physicians and other health care providers to acknowledge medical errors to their patients, by limiting the admissibility of such apologies in court.
Therefore, despite understandable feelings of guilt, embarrassment or fear which may leap to a physician’s mind upon discovering a medical error, causing her to hesitate in disclosing its existence or seriousness to a patient, full disclosure promotes a number of important interests for society, the individual patient, and the physician. Such benefits, and the recommended timing and components of an effective medical error disclosure, will be the subject of future blog posts.