Survey Shows Majority of Physicians Would Not Disclose Missed Cancer Diagnoses
A recent published survey of 300+ physicians faced with two hypothetical missed or delayed cancer diagnoses revealed that the majority of primary care physicians would not disclose relevant information to patients/families or apologize. Somewhere between 77 percent to 58 percent of the respondent physicians offered little to no information or apology when faced with the scenarios, according to the study funded by the National Cancer Institute. Now, if we want to be optimistic, we can rightly say that 10+ years ago the same survey would have probably yielded much drearier results -- I would guess 90 to 95 percent of physicians prior to the disclosure movement would have offered no information or apology. So, some progress has been made, but the authors of the study, led by researchers at Georgia State University and Kaiser Permanente Georgia, indicated they were expecting better numbers.
Here is a link for a news report on the study.
There were many factors and variables reviewed in the study, and the authors conclude by suggesting that risk, claims, and legal professionals need to understand why so many physicians (and other healthcare professionals) are reluctant to disclose information about potential errors with patients and families.
At Sorry Works!, we have a bunch of anecdotal evidence that explains the numbers seen in this study....our information comes from 11+ years of teaching disclosure and apology to clinicians in the field. Here is our take on what is happening:
1) Not enough clinicians were taught disclosure and apology in school. Some universities are adopting disclosure curriculum, but more work needs to be done in this area. Disclosure, apology and the broader issues or communication, customer service, relationships, etc are timeless issues that every student needs to understand before being turned loose in a clinical setting. Moreover, these topics should be part of required coursework...not optional lectures or elective seminars.
2) Not enough CME/CE programs are teaching (or reinforcing) disclosure principles. We have advocated in the past that disclosure/crisis communication principles should be mandated in the continuing medical education requirements for clinicians. Every doc or nurse will encounter multiple adverse events and angry patients/families in their careers, and clinicians need to understand how to handle these situations -- which means training and continual reinforcement.
3) There are not enough formal disclosure and apology programs within hospitals, insurers, and long-term care facilities. Disclosure is a scary topic, and clinicians need support and help...and this means formal programs with workable disclosure policies, the involvement of leadership and staff, and adequate promotion to continually reinforce the disclosure culture.
The bottom line is we have a lot more work to do in the disclosure movement.
A good tool to help clinicians understand how to properly address adverse events is the Little Book of Empathy. Priced from $9.99 to $4 per copy, the Little Book of Empathy is an economical and quick read that helps clinicians understand their role in the disclosure process. Click here to order your copies today.