You don't have to say you're sorry
But I sure do wish you would, I wish you would
(With apologies to Vanessa Williams)
My recent posting on malpractice cases prompted several comments to the effect that, if doctors did a better job disclosing errors and apologizing for mistakes, there would be fewer malpractice claims. That issue has been debated back and forth for some time, and it is difficult to prove one way or the other.
The Harvard hospitals, under the guidance of Dr. Lucien Leape, have endorsed general principles that could result in more disclosures and apologies when medical errors are made, but it will be up to each hospital and ultimately the hundreds of physicians therein to decide how to operationalize these principles. Similar discussions are going on around the country.
In the meantime comes a thoughtful and useful program at Mt. Auburn Hospital, in Cambridge, MA. The folks at Mt. Auburn noticed that individual doctors and nurses were often unsure if a given situation merited a disclosure and/or an apology and, if so, how to most compassionately and effectively deliver it. So, they created a team of administrators and doctors who are on call to help a doctor or nurse who might have committed an error. This team eliminates the isolation felt by a doctor or nurse in that uncomfortable and awkward position; provides a third-party perspective on the particular case; and can often make helpful suggestions of how to talk with the patient and family members.
We are currently reviewing the Mt. Auburn program to see if it or some variant would be helpful to our care providers and thereby to our patients and families. If you know of a similar program, I would be interested in learning about it.