Physicians are human, and humans sometimes err. Bad results can happen even when there is no breach of duty to the patient or neglect of the standard of care. And when there are errors or bad results, patients may be inclined to sue. Medicine is a mixture of art and science, and here’s one place where the “art” comes in.
When bad things happen, should physicians apologize to patients? “It depends,” according to Dr. Clifford Warren Lober, who holds both M.D. and J.D. degrees.
Make an effort to show concern, compassion, and empathy, he advised at the annual meeting of the American Society for Mohs Surgery. Patients are more likely to sue doctors they perceive as callous or unconcerned but “do not readily sue doctors they like,” said Dr. Lober of Kissimmee, Fla.
Some states prohibit expressions of regret, sympathy, or benevolence from being entered into trial evidence, so apologizing won’t necessarily help if a subsequent suit goes to trial. Plus, physicians should ask themselves how effective they are at communicating. If you come across as arrogant instead of sympathetic — not so good.
The “pro” side of an apology is that it may deflate the patient’s anger and make negotiations instead of a lawsuit possible. Patients may expect an apology — many claim they would not have sued if only the doctor had apologized, Dr. Lober said. Apologizing may be the ethically correct thing to do, help put closure on the problem for both patient and physician, and decrease physician feelings of guilt or distance from the patient.
On the “con” side, an apology may be misconstrued as legal weakness and encourage a lawsuit. It could be entered into evidence as an admission of guilt in some states, and malpractice insurers may consider it a breach of contract.
Best to talk to your attorney and/or your malpractice insurer before apologizing, he suggested. If you’re going to apologize, do it soon after the injury and make sure that you (the physician) apologize, not your nurse, attorney, or someone else.
Express sincere sympathy or remorse but never admit guilt, he said. How to do that? There’s the art of medicine. Medical conferences excel at sharing the science of medicine, but not much of the art. Surely some physician, somewhere, has drafted the right set of words that accomplish that balancing act. I’d love to hear some examples of how physicians have apologized to patients. It could help some of their less verbally concise colleagues do the same.