Comments on: Medicine means finally getting to say you're sorry

Medicine means finally getting to say you're sorry

scblackman — Mon, 10 Apr 2006 20:45:55 -0800

Physician, kneel thyself and apologize for your mistakes. Words can hurt, and words can heal. Can the words "I'm sorry" keep you from being sued? It seems like it. People are talking about physicians being empowered to apologize, including the Indiana General Assembly, Ira Glass, Lucian Leape, and even the entire Hah-vahd hospital system. Does your doctor need a little practice? Make her/him watch the handy instructional video.

By: caddis

caddis — Mon, 10 Apr 2006 21:20:35 -0800

Communication and apologies are the best malpractice insurance.

By: darksasami

darksasami — Mon, 10 Apr 2006 22:21:54 -0800

Against real people, yes. Against J. Random Subhuman Malpractice Suit Scammer, it's an admission of wrongdoing that will stand up in court. So it's a question for the game theorists.

By: nostrada

nostrada — Mon, 10 Apr 2006 23:18:57 -0800

I had to think of the book Blink - and of the SFGate review. I admit, I haven't read all the links above, sorry.

By: PeterMcDermott

PeterMcDermott — Tue, 11 Apr 2006 02:33:00 -0800

Against real people, yes Unfortunately, even real people tend to see a law suit as being directed against the hospital or the insurance company, and so even if they're quite happy with the doctor, faced with the possibility of a life-changing settlement, many, many people will still go after the money. And one of the articles seems to confirm that. Apparently, the evidence suggests that more people will sue, but the settlements/judgements will be smaller. Presumably because there's a realization that juries will no longer see the doctor as arrogant, but as a human, subject to the same errors and flaws as the rest of us, which takes away any desire to 'punish' him for his mistake. Good post, disappointing response.

By: OmieWise

OmieWise — Tue, 11 Apr 2006 04:26:36 -0800

This is something that's discussed a lot where I work, people are starting to feel strongly that apologies need to be part of good customer service. The stat I most like, however, comes from an observational study done at the hospital I work at. One group of docs were trained to let the patient completely finish describing their problems before talking themselves. It was found that the average patient only needed two minutes to completely state their problem. The untrained docs, though, interrupted after 30 seconds.

By: OmieWise

OmieWise — Tue, 11 Apr 2006 04:27:19 -0800

Uh, just untrained to let their patients talk themselves out. All of the docs were trained medical providers.

By: scblackman

scblackman — Tue, 11 Apr 2006 04:37:46 -0800

I've seen something like that to, but with an even shorter interval between the patient speaking and the physician interrupting (something like 18 seconds).

By: longdaysjourney

longdaysjourney — Tue, 11 Apr 2006 04:56:58 -0800

NPR ran a piece on the Michigan program a few years back. I tend to agree with the conclusions on both sides. (You're less likely to get sued if you apologize, but if you apologize and then still get sued, you're sunk. A rock and a hard place.) Separately, both Donna and Anthony told me that they believed they might not have sued had Donna's doctors just called to apologize. "They never felt any remorse," Donna said, "never called me after my son was born to say, 'I'm sorry this happened."' - A Wrongful Birth

By: blendor

blendor — Tue, 11 Apr 2006 07:54:45 -0800

I think they should have shown a more accurate reaction in the chemo overdose vid. I would expect more anger, yelling, or threats in a real life situation. They should show how to deal with that, too.

By: scblackman

scblackman — Tue, 11 Apr 2006 08:02:32 -0800

I agree, although (not surprisingly) there's quite a wide range of responses to physicians acknowledging that medical mistakes have been made. Many patients know, or hear about mistakes before they're formally told by their physicians, and are not always as surprised. Often there's silence, staring and fuming rather than out and out threats and yelling. Many patients are very reticent about threatening their physician, possibly because of fear that he/she will no longer take care of them. Remember, no matter how much you try, there is always a power differential between physician and patient. I've found, in my experience, that patients rarely yell and scream, and even in those cases, my approach is the same. Don't escalate, give patients time to vent their feelings, try to understand their perspective, and never go on the defensive.

By: davejay

davejay — Tue, 11 Apr 2006 11:38:47 -0800

That saying "I'm sorry" even has to go through this wringer of discuss (lawsuits and whatnot) is indicative of the sad state of things 'round these parts. Seems like nowadays, lots of people (regardless of profession, or lack thereof) seem to believe that if they do something accidentally, they "didn't mean it" and so should be absolved of all responsibility -- at the same time, lots of people (sometimes the same people, sometimes not) seem to believe that if someone else makes a mistake to their detriment (regardless of the extent of the damage, even if it's none at all other than wounded pride or slight inconvenience), that they "deserve" something in return other than a simple apology. No solution being offered here, just a lament.

By: davejay

davejay — Tue, 11 Apr 2006 11:39:18 -0800

discuss == discussion

By: ikkyu2

ikkyu2 — Wed, 12 Apr 2006 18:27:36 -0800

This isn't all that new a concept; I was taught about it at USC in 1995. I apologize to my patients occasionally - whenever I think I've wronged them, certainly. It's no big deal; it's hardly the same as kneeling or being humiliated. But I learned about this in grammar school, when my mom taught me to say "Please" and "I'm sorry," and my dad told me always to take responsibilty for my actions. Ill-bred people make bad doctors, just as they make bad adults of any other stripe.