Neurosurgeon Laments Dishonest Medical Culture; Urges Real Apologies
Neurosurgeon and attorney Dr. Lawrence Schlachter recently penned a column entitled “Medical Culture Encourages Doctors to Avoid Admitting Mistakes.” This column is not only a valuable read for clinicians and folks in risk, claims, legal, and c-suite, but also patients and families. We will use this column and other resources in our upcoming campaign to educate patients and families which will be launched in early March.
Dr. Schlachter warns patients and families to not always take what their doctor says at face value, especially when there are problems. According to Dr. Schlachter, terms like “accident,” “adverse event,” and “unfortunate outcome” might be softer ways of saying, “I screwed up but the system (or my training) won’t allow me to use truth telling words like ‘mistake’ or ‘error.'”
In the last paragraph of his column, Dr. Schlachter shares the following thoughts: “When a serious preventable medical error occurs, the physician who made it always has the option to do the right thing and fully disclose what happened. He or she can make an honest apology, which must include accepting responsibility for the error. He or she can also explain what options are available for compensation. Anything less is a pseudo-apology at best and a cover-up at worst.”
I love that last paragraph…own your mistakes. However, there are limitations to that passage. As we have written in past blog posts, many doctors and nurses are starting to speak truth telling words post-event — “I screwed up, it’s my mistake” — but physicians are often not in a position to offer money, or even talk about compensation with patients and families. In fact, most clinicians know little to nothing about the monetary aspects of potential medical errors, and we all know instances when clinical people can overstep their bounds: “Mrs. Smith, don’t worry about a thing…all of your daughter’s bills will be waived, and the hospital will pay for her entire rehabilitation.” The scientific term for such behavior is called “promising the moon.”
As we wrote in this blog post (and will again soon when we share the MedStar story), leadership/administration needs to be involved, be ready to back up staff, and be able to discuss the monetary issues and other fixes people (clinicians included) might need. In other words, to truly encourage real apologies and consistently hit the finish line with medical errors, you need a disclosure program.