CHICAGO - Radiologists should be sincere and authentic in delivering news of mistake to patients and families. Here’s what to consider after a medical error.
CHICAGO - Explaining a medical mistake to a patient is among the most difficult conversations a physician can have.
There are the inherent difficulties of admitting an error and its implications for a patient’s life, plus physicians may fear legal consequences and struggle with how much they can say, said speakers at RSNA 2013.
“For a long time we’ve thought of disclosure as a risk-management activity. People are now recognizing it’s an important part of quality and safety,” said Thomas Gallagher, MD, associate professor in the department of medicine and the department of medical history and ethics at University of Washington.
He described a movement away from disclosure being just a conversation that a doctor has with a patient but rather a process of preparing, having the conversation and following up.
There are many reasons physicians shy away from disclosure. Among them are:
Physicians also worry that disclosing errors proactively is a rush to judgment, that you shouldn’t talk with patients until all the facts are known, Gallagher said. Instead, he said, physicians must consider what stage the investigation is in when they prepare what to say to a patient.
Elaine Meyer, RN, PhD, a clinical psychologist at Boston Children’s Hospital, gave tips for having these conversations with patients.
The first priority should be assuring the patient that the clinical team will stay fully attentive to the medical needs of the patient.
In preparing for talking with the patient, you must first determine whether the event meets the threshold for disclosure by asking whether you would want this information as a patient or family member. Secondly, ask yourself whether the disclosure would change the treatment of the patient Meyer said.
Other things to consider, according to the experts:
It’s OK to say, “If I were in your shoes I would be upset and angry.”
And above all, be sorry, not just say you’re sorry, Meyer said. “If a patient doesn’t hear ‘I’m sorry,’ it’s hard to hear anything else,” she said.