Kiss and Tell?

About 300 years ago, the English author Alexander Pope famously wrote “To err is human, to forgive is divine.”

New research from the University of Illinois, Chicago concurs.  According to a study published in the November issue of Medical Care, people who believe their doctor or hospital would inform them if a medical error occurred are far more forgiving than those who doubt their health care provider would disclose the error.

A medical error is defined as a preventable adverse effect of care, whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete  diagnosis or treatment of a disease, injury or other ailment. Medical errors are one of the nation’s leading causes of death and injury and cost the US approximately $10 billion annually.  The Institute of Medicine estimates that as many as 300,000 patients are victims of medical errors, of which maybe as many as 200,000 people die.

In the new study, researchers surveyed a representative sample of Illinois residents regarding medical errors. About 40% of participants either had personal experience with medical errors, or had a close friend or family member who had been affected by an error.

Based on a hypothetical scenario, just 10% of survey respondents believed their physicians would be “very likely” to tell them if a medical error occurred. Yet, only a quarter said they would file a medical malpractice lawsuit if they were told about a medical error.

Respondents who trusted their doctor to disclose medical errors were no more (or less) likely to say they would sue. This was so even in a scenario where the health care provider offered to correct the problem through free additional medical treatment, and possibly a financial settlement.

However, people who trusted their health care provider to inform them about the error were more forgiving. Of the respondents who were most confident that their doctor or hospital would disclose the error, more than 60 percent said they would still recommend the provider, despite the error.

In contrast, only 30% of those who were skeptical about disclosure would continue to recommend the doctor or hospital.

The researchers found that although disclosure of medical errors is strongly preferred by patients, the most common policy is to “deny and defend” when errors occur because providers fear that it will trigger lawsuits and jeopardize their reputation.

The results show that patients perceived beliefs have a significant impact on their behavior. Patients who trust their providers to disclose errors may be no less likely to sue, but appear more likely to forgive. Conversely, patients who are most skeptical about disclosure may view their health care provider with “suspicion and frustration.”

Clearly when it comes to medical screw-ups, honesty is the best policy.