Saying "I'm sorry"

The New York Times ran an article this week about an experiment at the University of Michigan Health System, loosening the typical restrictions on doctors to apologize to their patients for medical errors. Malpractice lawyers and hospital legal departments generally discourage doctors from admitting mistakes to patients for fear of legal repercussions. But some health systems such as the one the University of Michigan are starting to questions whether this practice causes more harm than good. And a policy of honesty may actually benefit the bottom line, as well as benefit the mutual physician-patient relationship.

I have always contended that the key to communication in any relationship - physician-patient, professional colleagues, intimate partners - is mutual respect and trust. You cannot have an effective communication relationship without trust. And a doctor who stonewalls and does not admit to a medical error erodes the delicate balance of trust between doctor and patient. That doctor cannot expect that patient to ever be honest about his or her symptoms, health problems, or questions. Not admitting to an error telegraphs to the patient that the physician doesn't trust the patient and that the patient can't and shouldn't trust the physician. But a physician who trusts the patient enough to admit his or her mistake tells the patient that the physician is human, but that the physician values and trust the patient enough to allow him or her to see that. And that's how you build an effective patient-physician relationship where both parties play an active role in the patient's health care. I can only hope that more research like what is going on in Michigan will show physicians and health systems that honesty be a wise health and legal policy.

You can see the New York Times article here: http://www.nytimes.com/2008/05/18/us/18apology.html?ex=1368936000&en=c9496b7eb97e3235&ei=5124&partner=permalink&exprod=permalink