Patients' and Physicians' Attitudes Regarding the Disclosure of Medical Errors

Abstract

Context Despite the best efforts of health care practitioners, medical errors are inevitable. Disclosure of errors to patients is desired by patients and recommended by ethicists and professional organizations, but little is known about how patients and physicians think medical errors should be discussed. Objective To determine patients' and physicians' attitudes about error disclosure. Design, Setting, and Participants Thirteen focus groups were organized, including 6 groups of adult patients, 4 groups of academic and community physicians, and 3 groups of both physicians and patients. A total of 52 patients and 46 physicians participated. Main Outcome Measures Qualitative analysis of focus group transcripts to determine the attitudes of patients and physicians about medical error disclosure; whether physicians disclose the information patients desire; and patients' and physicians' emotional needs when an error occurs and whether these needs are met. Results Both patients and physicians had unmet needs following errors. Patients wanted disclosure of all harmful errors and sought information about what happened, why the error happened, how the error's consequences will be mitigated, and how recurrences will be prevented. Physicians agreed that harmful errors should be disclosed but "choose their words carefully" when telling patients about errors. Although physicians disclosed the adverse event, they often avoided stating that an error occurred, why the error happened, or how recurrences would be prevented. Patients also desired emotional support from physicians following errors, including an apology. However, physicians worried that an apology might create legal liability. Physicians were also upset when errors happen but were unsure where to seek emotional support. Conclusions Physicians may not be providing the information or emotional support that patients seek following harmful medical errors. Physicians should strive to meet patients' desires for an apology and for information on the nature, cause, and prevention of errors. Institutions should also address the emotional needs of practitioners who are involved in medical errors.

A survey of community members' perceptions of medical errors in Oman

“…This could explain increased community members awareness about medical errors. This finding is in line with what was found by Gallagher et al, that all participants were aware of the topic of errors in medicine [ 33 ]. However, Blendon et al found that 68% of the public were unaware of the meaning of medical errors [ 22 ].…”

Factors that prevent physicians reporting adverse events

“…Taking into account that there is no national system for reporting adverse events, no mentality for quality and that public hospital doctors complain about the care they have to provide to outpatients, it is natural to interpret why hospital‐based respondents agree with these notions. Our results are similar to other studies (Gallagher et al , 2003; Itoh et al , 2002, 2003, 2005; Kaldjian et al , 2006; Lawton and Parker, 2002), which identify sanction and disrepute fears, poor support and motivation as the main barriers to reporting adverse events.…”

Which medical error to disclose to patients and by whom? Public preference and perceptions of norm and current practice

“…Consistent with previous studies [5,10,13,14,17], we found that overall 95.5% of respondents preferred to be informed of ME. It is not known if this consistently expressed preference would change during an acute illness [10,41].…”