Some Doctors Donít Want to Disclose their Errors
A survey of medical professionals finds little consensus in attitudes about mistake disclosure. The survey of 2,600 medical specialists and surgeons found large discrepancies in how, and how often they were willing to discuss their mistakes with their patients.
The survey appeared in The Archives of Internal Medicine.
The survey authors presented medical practitioners with hypothetical, but plausible medical errors to determine how and if they would disclose the mistake, and which factors the doctors based their decisions on.
All of the hypothetical errors would cause serious injury.
When the doctor made an obvious error, like improperly writing a subscription resulting in an overdose, for example, only 81 percent of the doctors surveyed said they would definitely disclose the error to the patient.
The number of doctors willing to disclose their mistakes goes down when the mistakes are less apparent. Only 50 percent of the surveyed doctors think it is worth mentioning when the mistakes are less obvious. An example of one such mistake was overlooking a blood-chemistry, which can lead to serious complications.
When an error is obvious, the study’s lead author Dr. Thomas H. Gallagher said, “the doctor is thinking about what the patient really needs to know to understand what happened.”
The survey found that while surgeons were more likely to disclose an error, they were less likely to actually use the word, “error,” and more likely to disclose less information.
Overall, 56 percent of doctors said they would mention the problem, but only 42 percent would tell the patient that the problem was caused by their error.
The study also found that half of the doctors surveyed would disclose specific information about their error, and 37 percent said they would only offer partial information. Alarmingly, the remaining 13 percent said they would choose to reveal no details about the mistake unless the patient asked.
A mere third of the surveyed doctors said that they would apologize explicitly by saying something
like, “I am so sorry that you were harmed by this error.” One third said they would offer a general expression of regret such as “I’m sorry about what happened.”
The survey authors reported that some insurers encourage doctors to apologize under the assumption that this may prevent some lawsuits, or lead to smaller settlement amounts.
“People have suggested that, well, you just tell the truth, tell what happened,” Gallagher said. “But when you dig below the surface, there are all sorts of different components to the truth.” He continued to say, “Doctors and patients need to get better at having these conversations.”
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