No matter how dedicated a physician is to her medical practice, or how careful she is to avoid treatment errors when providing care to her patients, nonetheless mistakes cannot be entirely avoided. Furthermore, it must be acknowledged that physicians may at times be reluctant to disclose those errors to their patients based upon a myriad of legitimate concerns, such as damage to the physician’s reputation, wanting to appear capable and in charge, or fear of potentially initiating legal action or providing a harmful admission which could possibly be used in a lawsuit. Although such concerns are understandable, in recent years a number of benefits have been recognized of physicians willingly disclosing medical errors to their patients. Therefore, despite legitimate concerns which may cause a physician to hesitate in admitting a medical error or its seriousness to a patient, disclosure should be encouraged, as such promotes important interests for society, for the individual patient, and for the physician.
First of all, it should be noted that full and frank disclosure of medical errors fulfills the ethical responsibility of all physicians to be completely forthright with their patients. Moreover, open discussion of errors among all medical care providers facilitates more rapid recognition of dangerous patterns and other issues meriting attention and improvement. Thus, open dialogue promotes the general safety of all patients.
Additionally, admission of medical errors serves the important function of protecting, and hopefully strengthening, the important doctor/patient relationship. Discussion of an error can, in fact, enhance the trust of a patient in her doctor, and greatly improve the relationship going forward, by clearly demonstrating to the patient that the physician’s top priority is a true and unwavering concern for her health.
Finally, beyond the benefits to individual patients and to the patient population as whole, full and prompt admission of errors has the practical advantage to the physician of rapidly addressing, and perhaps reducing, feelings of patient dissatisfaction and distrust, as well as, perhaps, the desire to pursue legal action. In short, the physician will not compound the problem of having committed a medical error by also making the patient feel ignored and insulted. Indeed, as noted by Dr. Abigail Zuger in a New York Times article on July 15, 2014 which discussed how doctors are loath to apologize for non-preventable errors, “[s]tudies over the past decade have suggested a linear relationship between the quantity of apology offered for these errors and the quantity of cash saved by deflecting subsequent lawsuits.”
In sum, despite the understandable reluctance of many physicians to disclose medical errors, the foregoing benefits should be fully understood and appreciated by all medical care providers, in order that there be no hesitation to initiating open and candid discussions with patients when errors are made.
Common sense dictates, however, that in admitting medical errors, the manner in which the disclosure is made can have a significant impact upon the emotional state and resultant actions of the patient. The consequences of a poorly presented disclosure, and recommended timing and components of an effective disclosure, will be the subject of future blog articles.