Disclosing Medical Mistakes: A Communication Management Plan for Physicians
Re: Petronio S, Torke A, Bosslet G, Isenberg S, Wocial L, Helft PR. Disclosing medical mistakes: a communication management plan for physicians. Perm J 2013 Spring;17(2):73-79. DOI: http://dx.doi.org/10.7812/TPP/12-106
I was appalled to read the first words of this abstract: "There is a growing consensus that disclosure of medical mistakes is ethically and legally appropriate …"
It has always been appropriate to acknowledge ones' mistakes as soon as discovered, even if the patient is unaware. Forget "the plan" and do not weigh the consequences, but simply say to all in the room: "It's my fault"; "I made a mistake"; "I caused the problem"; "I'm sorry, but let's see if we can fix it." The patient will appreciate your honesty, realizing that we all make mistakes. To balk, question, or deny the mistake is not only wrong but greatly increases the likelihood of legal action.
The first half of my 40-year otolaryngology career was spent in private practice, and the last half at the Kaiser Permanente Santa Clara Medical Center. I certainly made my share of mistakes, but by following this path, not once was I threatened with legal action.
J Richard Gaskill, MD
Santa Clara Medical Center
Santa Clara, CA
Response to Dr Gaskill
Thank you for your response. We agree with Dr Gaskill that disclosure of medical mistakes has always been—and remains—the most ethically acceptable strategy. However, it has not always been the case that practitioners, risk managers, and health care administrators have been in favor of full and immediate disclosure. We appreciate Dr Gaskill's passionate advocacy of the ethical position of disclosure and for offering his opinion.
Sandra Petronia, PhD
lexia Torke, MD, MS
Gabriel Bosslet, MD, MA
Steven Isenberg, MD
Lucia Wocial, RN, PhD
Paul R Helft, MD