Balancing doctor egos and errors

The medical community's traditional response to dealing with medical mistakes-“deny and defend”-has come under fire in recent years. Critics say the approach is unfair to patients and their families, and that a more open and flexible process can defuse potential malpractice suits, improve the quality of healthcare and actually strengthen the doctor-patient relationship.

 

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Such was the case for Seattle-based internist Thomas Gallagher, MD, whose patient was too obese for a standard MRI and had to travel an hour to a facility that could accommodate him. However, technicians at the facility did not perform the proper level of imaging, resulting in Gallagher dealing with an upset patient and family who would have to make the trip again for a second scan.

The patient wasn’t harmed, and hadn’t threatened to sue. But Gallagher didn’t hesitate to explain the error and apologize for a mistake that wasn’t even his.

“Even a minor problem can be quite harmful to the well-being of the patient and the bond that exists between the patient and the doctor,” says Gallagher, who is executive director of the Collaborative for Accountability and Improvement, an organization that teaches communication and resolution programs for healthcare organizations, insurers and clinicians. 

Apologizing for mistakes, even relatively minor ones, is becoming more common in primary care. Doing it effectively-without getting into legal trouble-isn’t always easy.

As a plaintiff’s attorney for more than 20 years, Richard Boothman, JD, noticed that many clients simply wanted an explanation of what had gone wrong with their care and were suing out of frustration with the wall of silence around the “deny and defend” policy. 

 

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Now chief risk officer of the University of Michigan Health System (UMHS), which has three hospitals and 40 outpatient locations, Boothman has eliminated “deny and defend” and replaced it with a policy that is more transparent, conciliatory and open to admitting fault and providing compensation.

 

What small practices can do

Experts say that since any practice can be sued, even small ones, all of them need an apology policy.

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