Apology and Disclosure

Abstract

Program Description: Following errors and adverse events, the traditional legal and risk management advice to physicians has been to refrain from any disclosure or apology which might be used against the physician legally. Other factors which may inhibit disclosure and apology include a medical culture of perfection and a lack of experience with effective communication techniques. An increasing body of work has shown that the traditional technique of stonewalling is naturally infuriating to patients and is much more likely to lead to lawsuits. In addition, it places physicians in an intolerable position, since the natural human impulse of the caregiver is to apologize for mistakes and then to do everything possible to make things right. A number of non-profit organizations and a few forward-thinking malpractice carriers and institutions are now encouraging prompt, honest disclosure of adverse events, and apology when a genuine error has occurred. Experience to date has been that this more honest process is tremendously relieving to patients and physicians, and that malpractice suits and losses are substantially less when patients are treated honestly. In this miniseminar, three national experts on errors, disclosure, and apology, will discuss the ethical imperative for disclosure and the data that support this approach, both from a patient/provider satisfaction standpoint and a risk reduction standpoint. Doug Wojcieszak, the founder of Sorry Works! will speak about the advantages of disclosure and (when appropriate) apology from a patient perspective. Linda Kenney of Medically Induced Trauma Support Services will speak to how a culture of secrecy around errors harms both patients who are kept in the dark and physicians who aren’t able to be honest with their patients. Rob Hanscom, Vice President of Loss Prevention of Risk Management Foundation (a branch of Harvard’s medical malpractice carrier), will explain why insurance carriers may support thoughtful disclosure and apology policies. A discussion period will cover the issues of what and when to disclose to patients about adverse events, and the difficult question of when an apology is and is not appropriate. We will also present effective techniques for both disclosure and (when appropriate) apology.

Educational Objectives: 1) Understand the literature supporting disclosure and apology as the ethically appropriate response to adverse events. 2) Understand the evidence that disclosure and apology reduce the likelihood of litigation. 3) Know strategies to facilitate disclosure and apology after errors and adverse events.