Medical errors: How much do you tell?

Quick View. Sept. 11, 2006.

What kind of medical errors are you willing to disclose to patients?
Serious error	98%
Minor error	78%
Near miss	35%
What can make a decision to disclose medical errors to patients less likely?
Patient won't understand	60%
Patient won't want to know	30%
Patient is unaware of error	21%
I might get sued	19%
Don't know patient very well	13%
Patient may get angry	10%
How much do you disclose to patients?
Mention adverse event but not error	56%
Explicitly say that error ocurred	42%
None	3%
How do you say you're sorry?
Express regret	61%
Explicitly apologize	33%
Offer no apology	6%
What future steps will you take to avoid errors?
Give nonspecific pledge	54%
Present specific steps	37%
Give no information	9%

Canadian physicians are only one-fifth as likely to get sued as American doctors are, but their attitudes about whether and how much to disclose to patients about a medical error are remarkably similar.

For example, 66% of U.S. surgeons surveyed said they had disclosed a medical error to a patient, compared with 65% of Canadian surgeons, according to Thomas H. Gallagher, MD, associate professor of medicine and medical history and ethics at the University of Washington School of Medicine in Seattle.

"These attitudes may stem much more strongly from the culture of medicine than from the external malpractice environment," said Dr. Gallagher, who led a team that surveyed 2,367 physicians in Canada and in Washington and Missouri -- two states classified as "in crisis" on the AMA's medical liability map.

Because of the similarities, other results from the survey are not broken out by nation. The findings suggest that while physicians are nearly unanimous in believing serious errors should be disclosed to patients, they disagree about how much should be disclosed.

Note: Figures may not add up to 100% due to rounding.

Source: "U.S. and Canadian Physicians' Attitudes and Experiences Regarding Disclosing Errors to Patients" and "Choosing Your Words Carefully," both in Archives of Internal Medicine, Aug. 14/28

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