To Apologize or Not to Apologize?

There is a general idea within the medical community that offering an apology to a patient is an admission of guilt, and can result in a malpractice claim. A recent study conducted at 2 large Massachusetts hospitals disagrees, and actually supports the exact opposite.¹ Offering explanation, apologies, and ensuring that steps are being taken to keep the same error from happening again, tends to lower the amount of litigation arising from medical errors.

Iatrogenic Injuries

Iatrogenic injuries are a major cause of death in the United States, and lawsuits are a major concern for physicians and health care facilities. These concerns are part of a general medical atmosphere, and are voiced by holistic practitioners as well – though holistic practitioners experience far less litigation by comparison. New hospital programs supporting open communication, apology and resolution (CARe) may help explain why naturopaths and other holistic practitioners get sued less, and may want to reconsider the dominant idea that to apologize is to admit guilt.

Study Stats

The study, led by Michelle Mello, JD,PhD looked at 6 hospitals that implemented CARe programs over a two year period of time (between 2013 and 2015). The program included nearly a thousand cases that met a threshold that made each case likely to bring with it a lawsuit. The program revealed an incredible drop in malpractice claims to only 5% (5 percent of the cases that were funneled into the program actually resulted in a lawsuit). When the program did compensate the average payment was $75,000 compared with an overall national average of $225,000 for malpractice lawsuits.

Findings

The findings of the study support communication-and-resolution programs as more effective ways of addressing medical errors. The explanation given for this is that by communicating with patients in an honest way their anger is defused. But more than that, patients are included in the process of their health care, something that holistic practitioners hold as a crucial part of the patient-doctor relationship. In essence, this study demonstrates that the manner in which naturopathic physicians and other holistic practitioners relate to their patients – with respect and honesty – is actually a principal reason why they experience less litigation.

Source

1. Moore J, Bismark M, Mello MM. Patients’ Experiences With Communication-and-Resolution Programs After Medical Injury. JAMA Intern Med. 2017

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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.