Views of Practicing Physicians and the Public on Medical Errors

Abstract

Though substantial proportions of the public and practicing physicians report that they have had personal experience with medical errors, neither group has the sense of urgency expressed by many national organizations. To advance their agenda, national groups need to convince physicians, in particular, that the current proposals for reducing errors will be very effective.

Apologies and Medical Error

“…The source of an adverse outcome may be difficult to ascertain or the outcome may be multiply determined. However, in dealing with this complexity, physicians should recognize they tend to be disinclined to recognize error even when it occurs [56] and that there is a tendency to avoid directly apologizing even for clear errors [3,5,11], and consciously attempt to counter these tendencies. In any case, a patient who sustains an adverse outcome should be provided with full information about the nature of the complication, his or her injuries and prognosis, and any resulting necessary treatment.…”

“…For example, in one survey, only one-third of both physician and nonphysician respondents who had experienced a medical error in their family reported they had received an explanation or an apology for what had happened [3]. Another survey of patients who brought suit found 40% reported not receiving an explanation; in only 13% of cases did patients report responsibility for what had happened was accepted either in part or in full and in only 15% of cases did patients report receiving an apology [54].…”

A Call To Excellence

“…1 A recent survey conducted by the Henry J. Kaiser Family Foundation showed that 42 percent of the public and 35 percent of physicians polled reported that they or a member of their family had experienced an error in care. 2 This is encouraging be-cause it suggests that we may be close to a "tipping point" for change. However, the results also indicate that neither patients nor clinicians fully appreciate the importance of systems to making improvements.…”

Error in Medicine: The Role of the Morbidity and Mortality Conference

“…Studies on physicians' views of error disclosure, however, reveal a fundamental discordance. A survey of physicians who had experienced errors in their own medical care or in that of a family member found that, while more than 70 percent assigned "a lot" of responsibility for the error to the physicians administering that care, less than 25 percent believed that mandatory hospital or voluntary physician error reporting would be a "very effective" solution [10]. Only a very few physicians even viewed medical errors as a major problem.…”

“…Only a very few physicians even viewed medical errors as a major problem. Most study participants thought medical error was less important than the mounting burdens of malpractice insurance, the rising cost of health care, and the problems with insurance companies and health plans [10]. Similarly, interviews with physician focus groups have shown that, while the majority of doctors believe that the disclosure of medical errors that result in serious harm is an ethical imperative, they simultaneously admit to many situations in which they might not disclose such error [11].…”