But as for saying you’re sorry, that’s akin to slipping a noose around your own neck, right? Wrong. Today, at least 34 states have some form of an “Apology” law, which essentially makes a physician’s apology to a patient for a negative treatment outcome inadmissible as evidence in a court of law.
This theoretically offers you some legal protection, although “it’s always been good to say sorry,” says Doug Wojcieszak, founder of the Sorry Works! Coalition, which trains physicians and hospitals on how to disclose medical errors, apologize appropriately, and, when necessary, offer upfront compensation.
But why, exactly, would you be saying you’re sorry? To apologize for committing a medical error, and therefore malpractice? Or to offer comfort to a fellow human being who is suffering? The difference is critical. The first is an admission of guilt, while the second is an expression of remorse.
Apologizing might still result in you being sued, although only about one-eighth of patients injured annually actually do sue. Again, your positive relationships with your patients — or lack thereof — will play into your patients’ decision.
Merely expressing sympathy, without accepting blame, reveals your ability to sense another’s suffering. Feeling and communicating true remorse is critical, regardless of guilt, because it shows your patient that you feel terrible that she is in pain. Choosing this path, though, may ring hollow if, in fact, you are to blame. Regardless, remorse is essential to give closure to both you and your patient.
As to the effectiveness of “Apology” laws, Wojcieszak knows defense lawyers who say they’d never invoke an “Apology Law” to protect their clients. Makes sense. After all, the impression given by a contrite physician doesn’t exactly help a plaintiff’s case in terms of the size of the award.
“How do you make a guy look bad who just apologized and is trying to do the right thing?” asks Wojcieszak. Juries will likely react with sympathy for a remorseful, humble human being, as opposed to condemnation for a silent, self-righteous schmuck.
Not sure how to go about developing this “sorry” skill? Get some training. You’ll find one such venue is on the Sorry Works! Coalition Web site. If you’re concerned your apology to a patient may go awry and get ugly, consider securing the services of a mediator or even an arbitrator. The National Arbitration Forum can help you determine a course of action.
Many major hospitals are also starting to institute “I’m Sorry” programs, including Harvard Medical School, Johns Hopkins Medicine, Allina Hospitals & Clinics, Veterans Affairs Medical Center in Lexington, Ky., and University of Michigan Health System in Ann Arbor. Get on board if your own hospital has such a program.
Don’t just say it
The last step is to make restitution. Again, a mediator or arbitrator can help you with this, if need be. However if you choose to do it, “make every effort to make things right,” says Grossman. “Offer to operate for free,” if that makes sense. Again, if you’ve been doing things right all along (and again, see above section), you’ll more likely find a fellow problem-solver in your patient rather than an adversary.
You’ll also find that there’s nothing like restitution to allow you to forgive yourself for making the mistake — also critically important.
Preventing trouble is preferable to resolving it. But there’s no way to remove risk completely, says Segal. “The best way to never be in a car accident is never to drive,” he says. True, a pedestrian can still get plowed by a bus. But hiding out in one’s house to avoid any injury makes for a less-than-fulfilling existence.
So practice medicine in the best way you know how, taking reasonable precautions to protect yourself against a lawsuit. Your patients will sense any paranoia you might be trying to hide, which will only serve to undermine the trusting relationship you have with them. Remember, Segal says, “Most people don’t want to sue; they want to get healed.” And you’re just the doctor to do it.
