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Making Disclosure A Reality For Healthcare Organizations 

Medical School Dean on Teaching Disclosure & Apology

docThis Tuesday, January 17th, I will have the privilege of being the Keynote Speaker at the Inter-Professional Education & Practice Collaborative at The Ohio State University.   I will be speaking to over 1,000 students and faculty in every health profession school at OSU.  This is the third year I have had the privilege of providing this talk, and, to be frank, I wish I had more of these engagements.  In three to four years these incredibly bright students will scatter around the country (and the world), and take the message of disclosure and apology with them.   Powerful stuff. We need to do so much more work teaching disclosure and apology to healthcare students -- not just medical students but also nursing, dental, vet med, etc.   We should also consider law students and as well as business students who envision a career in the insurance industry.  Get them while they are young.

Two weeks ago I shared the story of a medical student -- Mr. Jason Han -- who apologized for a medical error by reflecting on a medical error he experienced as a teenager that left him deaf in one ear.  Powerful story.  Well, this week I want to share with you an article written by the Advisory Dean at Jason's medical school.  It's an important article from a professional medical educator about the issues we need to consider when teaching students how to confront medical errors, how to communicate with patients and families, and also how to deal with their own emotions. 

Bottom line is it's not good enough to teach "science" to healthcare students -- we must also make them emotionally smart.  

Here is the article from the Medical School Dean, and directly below is the original article about Mr. Han's apology.

Medical Student Apologizes by Reflecting on Medical Error He Suffered, originally published Jan 4, 2017

Fourth year medical student Jason Han has a unique perspective on medical error and lack of disclosure. As a teenager, Jason and his mom visited his pediatrician for an ear ache. The pediatrician attempted to irrigate Jason's ear with a large syringe that was too large, and burst Jason's ear drum, leaving him deaf in that ear. The errant physician assured Jason and his mom that everything was normal, and then refused to return phone calls or any answer inquiries about the incident. Jason said the fact that his physician lied to him and betrayed his family was actually worse than the physical pain.

Fast forward and Jason Han is now a fourth-year medical student at Perelman School of Medicine at the University of Pennsylvania. Recently, a patient suffering from heart failure needed an arterial catheter inserted, and Jason volunteered for the task. Unfortunately, Jason struggled and caused his patient unnecessary pain, and a resident had to complete the procedure. Jason told the Philadelphia Inquirer that he felt ashamed and quickly left the room without saying anything to the patient -- but then it dawned on Jason that he was acting no differently than his pediatrician ten years ago. Jason quickly went back to the patient and apologized, and the patient graciously accepted the apology. The article concludes by saying that the Perelman School of Medicine will be teaching disclosure to their medical students, and Jason believes such training would have helped him. Here's the article.

This story gives me hope as we start the New Year. In my work with medical schools and residency programs, I am hearing more and more young people saying a) they can't imagine doing any other than disclosure and apology for errors and b) they are shocked that deny and defend was accepted practice for decades. However, we need to train our students...showing them how to disclose and apologize for medical errors needs to be mandatory in the curriculum for all health professionals. Moreover, I have often said that the greatest advocates for disclosure are physicians and nurses who have experienced medical error in their own care (or the care of a family member). Jason Han is one of these important advocates. Finally, we need to provide training to the folks who didn't learn disclosure in school.

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