Disclosing Medical Mistakes: A Communication Management Plan for Physicians

Disclosing Medical Mistakes: A Communication Management Plan for Physicians

[Letter]. Perm J 2013 Fall;17(4);94

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: https://doi.org/10.7812/TPP/12-106

Dear Editor,

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

Retired Otolarygologist

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




27,000 print readers per quarter, 11,225 eTOC readers, and in 2017, 1.5 million page views on TPJ articles in PubMed from a broad international readership.

The Permanente Press

The Permanente Journal (ISSN 1552-5767) is a peer-reviewed journal of medical science, social science in medicine, and medical humanities published quarterly by The Permanente Press.


Physicians may earn up to 1 AMA PRA Category 1 Credit per article for reading and analyzing the designated CME articles published in each edition of TPJ.

ISSN 1552-5775 Copyright © 2018 thepermanentejournal.org.

The Permanente Press. All Rights Reserved.