If you practise medicine for any length of time, you’ll inevitably end up being involved in a situation where a patient has been harmed due to medical error. Open disclosure to the patient is not only expected, it’s often mandated by the healthcare provider. And a key element of open disclosure is an apology to the patient or their family, using the words “I’m sorry” or “we are sorry”.
It’s by no means easy to do. Saying sorry in a medical context is so much more difficult than in other situations, according to a new interview-based study on apology in medicine, because the stakes are so high.
“As a doctor, the problem is much more serious than anything you encounter in everyday life,” one of the doctors interviewed for the study said. “When it concerns more important problems, it costs me more to make the effort to go and apologise, I say to myself, I have to through with this.”
Another barrier to apologising for medical error, the study suggests, is the fear of being blamed and fear of a demand of compensation by the patient affected. But actually, research shows that in medicine, as in other fields, apologies help resolve conflicts and litigation and are associated with fewer malpractice suits.
All Australian jurisdictions have so-called “apology laws” that protect doctors who apologise for adverse events from liability before the law. The aim of such legislation is to create an environment where doctors can express regret without it being used against them in any future litigation.
An effective apology is critical to allowing the doctor-patient relationship to continue despite what has happened, and minimises the chances of a complaint against the healthcare provider. Getting the wording right is also crucial, and should include the word “sorry”, using formulations such as “I’m sorry this has happened”, or “I’m sorry this hasn’t turned out as expected”.
Here are some tips on how to say sorry after medical error.
- Acknowledge that the error has occurred;
- Apologise and/or express regret for what happened;
- Be careful about wording. Make sure you use the word ‘sorry’, but avoid saying you personally are liable or speculating on what staff members were at fault;
- Go through the facts as you know them, and what you expect will happen next;
- Listen to what your patient has to say on the matter;
- Let your patient know what is being done to ensure a similar event won’t happen again.
For more information on open disclosure, click here.
Interested in learning more? Professor Stewart Dunn will be moderating workshops in Sydney on complex communication in health care. The workshops will cover open disclosure, breaking bad news, end-of-life conversations and dealing with conflict in the workplace. Read more about the workshops and sign up here.