A recent oft-cited study showed that doctors who who apologized for mistakes were less likely to be sued. My initial reaction to that is to file it under \”duh.\”
But then I was greeted with a note lying on my desk.
Dr. Rob:
First, I want to tell you that for the majority of the many years my family has been patients of your practice, I believe we received excellent care and you always had our best interests in mind. Further, we appreciate all that you and your staff have done for us.
However, it is with great regret that I find myself in the position of writing to you with a problem I see as pervasive in your practice…
Ugh. This is not the way to start my day.
The letter went on to describe a problem with communication of a concern the patient had about a medical problem that was very worrisome to her. It didn\’t point the finger of blame at my nurse, nor any one else in the office. It wasn\’t at all angry in its tone to me. It simply expressed the disappointment of a patient who felt let-down by her physician.
The letter ended with:
I look forward to speaking with you about this issue early in the week of July 20.
Thank you in advance for your attention to this matter.
I put off calling her until the end of the day. I knew she would be reasonable overall, but beyond the fact that I hate calling people on the phone at all, I hate calling when I know I have to apologize. The problem in this case was not with my staff or with confusion in the office. The problem was with a physician who simply dropped the ball and did not follow-up as promised.
I finally called:
Hi.
First let me say thank you for the letter you sent. I mean that sincerely. I would much rather hear about problems in our office than to simply having people get angry and leave. This is something I needed to hear.
Second, let me say that the blame is 100% mine. I really wasn\’t worried about the problem and so I honestly just let it slip my mind. I did tell you I\’d contact you and would send you to a specialist if things weren\’t clear after the tests I ordered. I\’m sorry about that.
I went on to discuss the situation and that I didn\’t think anything was serious at all. She still wanted to go ahead with the consultant because of some stuff she had heard about the condition. I told her that I have no problem with that, as I see my job as one of giving my advice and perspective; but not as making the final decisions. The most important thing is that her worries are addressed and that she feels comfortable that everything is OK. If it takes a consultant to do that, then I have absolutely no problem with that.
I also explained that communication in a medical office is very difficult – and has gotten much harder as we have gotten busier. It is our plan to eventually have communication by e-mail, but that is not ready for prime-time. This is not an excuse, I told her, but an explanation and a promise that I do see the problem and we are doing something about it.
As expected, she was gracious about the situation and was thankful for the apology. I didn\’t do it to avoid lawsuit or to protect myself. I like this family and didn\’t want to lose them as patients. Beyond that, though, I owed her an apology. I had let her down. I hadn\’t done what I promised I would do. She had been kind enough to send me the letter and deserved a quick resolution to the situation.
I still hated picking up the phone, though. It isn\’t easy to admit fault, no matter how accepting you know the other person will be.
As obvious as it seems that apologizing will prevent lawsuit, it is a hard thing to do.
But I am glad I did.
Good job!I hate whenI have to apologize to a customer for a mistake that I made. There are several doctors that I’d love to have an apology from, but……
Good job!I hate whenI have to apologize to a customer for a mistake that I made. There are several doctors that I’d love to have an apology from, but……
Good for you. The results of this study are not surprising or even news. But so few docs get it.
I was injured in the OR recently. What happened to me should have generated a sentinel event report. But while I’m in some extra pain and my recovery will be a bit delayed, I wasn’t planning to sue because everything should turn out OK.
At my postop visit, my surgeon made a point to not only not apologize, but to blame me for the injury. (His theory for blaming the anesthetized victim was fascinating and unsupportable, I wondered if it originated with his malpractice insurer…)
I went in to his office laughing about it. His attitude has me not laughing. And since any jury would award me money for this, only MY sense of medical and legal morality is letting him keep laughing.
I didnt want to sue. An “I’m sorry- it shouldn’t have happened” would have kept it that way. His own behavior is tempting me to sue the grin off his face.
Good for you. The results of this study are not surprising or even news. But so few docs get it.
I was injured in the OR recently. What happened to me should have generated a sentinel event report. But while I’m in some extra pain and my recovery will be a bit delayed, I wasn’t planning to sue because everything should turn out OK.
At my postop visit, my surgeon made a point to not only not apologize, but to blame me for the injury. (His theory for blaming the anesthetized victim was fascinating and unsupportable, I wondered if it originated with his malpractice insurer…)
I went in to his office laughing about it. His attitude has me not laughing. And since any jury would award me money for this, only MY sense of medical and legal morality is letting him keep laughing.
I didnt want to sue. An “I’m sorry- it shouldn’t have happened” would have kept it that way. His own behavior is tempting me to sue the grin off his face.
That was the smart, and the right thing to do. It showed that patient that you cared about her, and that you were man enough to address her concerns, and take responsibility for your side of it (there are those that will squirm their way around an issue and attempt to deflect blame). Patients can understand you are human. You have so many patients to care for and so many things to take care of in a day. An apology and a quick attempt to correct the situation will save both parties further upset. Open communication and genuine concern go a long way. Good job, Rob.
That was the smart, and the right thing to do. It showed that patient that you cared about her, and that you were man enough to address her concerns, and take responsibility for your side of it (there are those that will squirm their way around an issue and attempt to deflect blame). Patients can understand you are human. You have so many patients to care for and so many things to take care of in a day. An apology and a quick attempt to correct the situation will save both parties further upset. Open communication and genuine concern go a long way. Good job, Rob.
Fantastic job, Rob! I just read a study (might have been the same one) on this and was getting ready to send it to on to our providers but I think I’ll just send your blog instead!
Fantastic job, Rob! I just read a study (might have been the same one) on this and was getting ready to send it to on to our providers but I think I’ll just send your blog instead!
Right on, Dr. Rob! You get a gold star for excellent communication. Now if we could only get the rest of the world to be up-front, honest and thoughtful…
Right on, Dr. Rob! You get a gold star for excellent communication. Now if we could only get the rest of the world to be up-front, honest and thoughtful…
Wow.. Rob! I’m impressed!
So many people aren’t willing to own up to their mistakes and in the medical arena.. understandably… they worry about being sued.
If I were your patient…I’d have even MORE respect for you and trust you even more. I would also feel good about you’re caring enough to set things straight and would cause me to feel like I am in good hands.
It sounds as though you both are better off for your having done that. Life is a learning process and things happen… sometimes through omission. She sounds like a very reasonable person and a good communicator herself.
Some people might be afraid to speak up, but this is a good example of why it is important to.
Wow.. Rob! I’m impressed!
So many people aren’t willing to own up to their mistakes and in the medical arena.. understandably… they worry about being sued.
If I were your patient…I’d have even MORE respect for you and trust you even more. I would also feel good about you’re caring enough to set things straight and would cause me to feel like I am in good hands.
It sounds as though you both are better off for your having done that. Life is a learning process and things happen… sometimes through omission. She sounds like a very reasonable person and a good communicator herself.
Some people might be afraid to speak up, but this is a good example of why it is important to.
My doctor whom I deeply admire and respect did something thoughtless, which could have turned out quite badly, but fortunately didn’t. He ate something with nuts (I am highly allergic) before my exam and somehow his hand scrubbing didn’t get the rid of the oils and when he did my breast exam my boobs lit up like xmas trees. It was AWFUL.
It makes me laugh now, because the reaction was INSTANT, and I am grateful nothing serious other than being uncomfortable and sleepy from the antihistamine. He apologized and I was shocked. I didn’t realize doctors actually did that.
His humanness made me like him a whole heap more.
My doctor whom I deeply admire and respect did something thoughtless, which could have turned out quite badly, but fortunately didn’t. He ate something with nuts (I am highly allergic) before my exam and somehow his hand scrubbing didn’t get the rid of the oils and when he did my breast exam my boobs lit up like xmas trees. It was AWFUL.
It makes me laugh now, because the reaction was INSTANT, and I am grateful nothing serious other than being uncomfortable and sleepy from the antihistamine. He apologized and I was shocked. I didn’t realize doctors actually did that.
His humanness made me like him a whole heap more.
How does your malpractice insurer feel about this? Apologizing may decrease your risk of being sued, but if you are sued, it is an admission of liability. In America these days virtually every physician gets sued sooner or later. The attorney they assigned me said “Don’t apologize. Don’t discuss it. With anybody. Period.” I didn’t feel too bad about that because I didn’t feel I’d d0ne anything wrong. But I’m sure plaintiff’s attorney would have been happy to tell the jury I had admitted wrongdoing.
-RR-
How does your malpractice insurer feel about this? Apologizing may decrease your risk of being sued, but if you are sued, it is an admission of liability. In America these days virtually every physician gets sued sooner or later. The attorney they assigned me said “Don’t apologize. Don’t discuss it. With anybody. Period.” I didn’t feel too bad about that because I didn’t feel I’d d0ne anything wrong. But I’m sure plaintiff’s attorney would have been happy to tell the jury I had admitted wrongdoing.
-RR-
If it is a true issue of medical error or misjudgment, I wouldn’t jump as quickly to call. This was, however, an issue of poor service and communication. I had simply not done what I said I would. No harm at all was done, so it was not an issue of malpractice. In the case that it is, I still think the article gives a good case for not being elusive.
If it is a true issue of medical error or misjudgment, I wouldn’t jump as quickly to call. This was, however, an issue of poor service and communication. I had simply not done what I said I would. No harm at all was done, so it was not an issue of malpractice. In the case that it is, I still think the article gives a good case for not being elusive.