Medscape Article: Should Docs Rethink "I'm Sorry" After Medical Error?
Two weeks ago Medscape released an article questioning the efficacy of the disclosure movement. Led by apology critic Victor Cotton, MD, JD, the story brought up familiar challenges to disclosure & apology, including why would a patient not sue a doctor who said "sorry" for causing life-changing injuries (or death)? I find it amazing after doing this work for 14+ years that well-educated people still do not get (or want to get) that apology coupled with an offer of fair, upfront compensation (as well as other acts of contrition) can indeed reduce the need and/or desire for litigation. It's really common sense, but some people -- almost in a silly way -- will retort, "But how can 'sorry' stop a lawsuit?" Silly and stupid. Again, they don't understand (or want to understand) the meaning of true apology....
What I really found unsettling about the article was the comments written by physician readers of the article. Many of these commentators were surgeons, and most had a negative view of disclosure. Again, I was shocked by the basic misunderstandings of highly trained people, namely confusing empathy ("I'm sorry this happened") versus apology ("I made a mistake....I am sorry for this error"), or that not every bad outcome requires apology, but you need to say something to family, and empathy is a really good choice! Moreover, many of the surgeons believe the new standard is fall on your sword every time something goes wrong in the operating room -- no!!! Finally, there is such confusion about what apology is, and I believe the reason is people don't have a firm group on the difference between empathy and apology. A big part of this problem is the numerous medical, legal, and risk management texts on disclosure that confuse apology and empathy with phrases such as, "Apologize, but don't admit fault."
If you want to see what we are still up against, read those comments carefully. It's a nasty mixture of fear, arrogance, and ignorance. Long term, the solution starts in our medical schools and residency programs.
This past week the Leapfrog Group released a statement pushing for the "adoption of expanded medical error policy" within hospitals that would include apology for errors. Love it, but to make this reality we are going to have deal with the reality that was presented to us in the Medscape article. Again, the long-term fix can be found in our medical schools and residency programs. Sorry Works! is launching a research project this fall to study what is being taught about disclosure in our nation's 175 medical schools, and make recommendations for uniform curriculum. We are raising funds to support this project. To make a tax deductible donation to support these research projects, click on this link.
Doug Wojcieszak, Founder and President
618-559-8168 (direct dial)