This is a blog by a former CEO of a large Boston hospital to share thoughts about negotiation theory and practice, leadership training and mentoring, and teaching.
Sunday, January 10, 2010
Saying sorry
Natasha Singer writes this interesting article about apology in the health care world in today's New York Times. I'm quoted briefly at the end. Would love your comments.
well said! no one is perfect, and doctors should be honest and responsible. what we want is good and honest services. hope you can put your words into action!
I think in cases of clear cut error, such as wrong site surgery or the horrendous case at my hospital where a lymph node dissection from a mastectomy for cancer was accidentally thrown in the OR trash, an apology is truly the least an organization can do. However, there are still those gray areas where an expression of regret can and is interpreted as admission of error. For instance, I do not believe that every single case of infection contracted in a hospital is a medical error, but some patient advocates do. I would love to hear from some malpractice attorneys regarding their experiences with this issue.
Great Article - I think that "I'm Sorry" is not said enough in our society.
We work with hospitals on how to use technology to reduce falls, but we have found that it's not enough. So, we encourage additional items such as appologize for the incident, explain what happened, and let them know how they are working to fix the issue. The research we have done indicates that these steps will reduce litigation costs, and improve patient family relations.
Not that a restaurant is a good analogy but Are you more or less angry at a restaurant if the wait staff comes to your table to tell you that they messed up your order and will be fixing it right away? Instead of bringing you the burnt piece of toast and thinking you won't notice.
While evidence suggests litigation metrics are reduced at an institutional level when full disclosure is embraced, one can imagine why an individual professional might hesitate, especially in the case of an error deemed inconsequential.
However, physicians are bound by ethical principles that put a patient's interests above their own. In covering an error, this hierarchy is reversed. Misdirection or silence compromises a patient's right to autonomous decision-making by restricting potentially influential information.
Moreover, estimating the scope an error's consequence is subjective at best. The determination of therapeutic privilege should not be made by the practitioner responsible for the mistake, if this privilege exists at all.
Apologizing for a mistake is the right choice, but the current litigomania culture makes it hard for physicians and others to do the right thing. I have apologized to patients when I needed to do so, but worried that this would increase my legal vulnerability. I have been involved (?ensnared) in several medical malpractice cases over the years. I was innocent in every case and dismissed from every one of them. No one apologized to me. My current posting is a view on tort reform authored by a plaintiff's attorney. http://bit.ly/7ESPzk
well said! no one is perfect, and doctors should be honest and responsible. what we want is good and honest services. hope you can put your words into action!
ReplyDeleteI think in cases of clear cut error, such as wrong site surgery or the horrendous case at my hospital where a lymph node dissection from a mastectomy for cancer was accidentally thrown in the OR trash, an apology is truly the least an organization can do. However, there are still those gray areas where an expression of regret can and is interpreted as admission of error. For instance, I do not believe that every single case of infection contracted in a hospital is a medical error, but some patient advocates do.
ReplyDeleteI would love to hear from some malpractice attorneys regarding their experiences with this issue.
nonlocal MD
Great Article - I think that "I'm Sorry" is not said enough in our society.
ReplyDeleteWe work with hospitals on how to use technology to reduce falls, but we have found that it's not enough. So, we encourage additional items such as appologize for the incident, explain what happened, and let them know how they are working to fix the issue. The research we have done indicates that these steps will reduce litigation costs, and improve patient family relations.
Not that a restaurant is a good analogy but Are you more or less angry at a restaurant if the wait staff comes to your table to tell you that they messed up your order and will be fixing it right away? Instead of bringing you the burnt piece of toast and thinking you won't notice.
I appreciated your quote!
ReplyDeleteWhile evidence suggests litigation metrics are reduced at an institutional level when full disclosure is embraced, one can imagine why an individual professional might hesitate, especially in the case of an error deemed inconsequential.
However, physicians are bound by ethical principles that put a patient's interests above their own. In covering an error, this hierarchy is reversed. Misdirection or silence compromises a patient's right to autonomous decision-making by restricting potentially influential information.
Moreover, estimating the scope an error's consequence is subjective at best. The determination of therapeutic privilege should not be made by the practitioner responsible for the mistake, if this privilege exists at all.
Apologizing for a mistake is the right choice, but the current litigomania culture makes it hard for physicians and others to do the right thing. I have apologized to patients when I needed to do so, but worried that this would increase my legal vulnerability. I have been involved (?ensnared) in several medical malpractice cases over the years. I was innocent in every case and dismissed from every one of them. No one apologized to me. My current posting is a view on tort reform authored by a plaintiff's attorney. http://bit.ly/7ESPzk
ReplyDelete