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Which medical errors should doctors disclose?

Historically, doctors have avoided disclosing the majority of medical errors to their patients out of fear of being sued for medical malpractice and because they were uncomfortable with the disclosure process. However, increasing numbers of doctors, including some in the Norman area, have come to see full disclosure of medical errors to patients as the best practice to follow.

What is full disclosure? A full disclosure of medical errors should include revealing every harmful error that occurred, ways to minimize their effects and explanations about why the errors occurred. In addition, the disclosure should include a statement about what steps will be taken to prevent recurrences, an acceptance of responsibility for the errors and an apology.

Doctors may advocate full disclosure, but in practice they often use carefully chosen words that make it difficult for patients to understand the full effect of the errors on their health. Doctors are usually scared of fully disclosing medical errors because they fear their admission will be used against them in any lawsuit for medical malpractice.

What is a limited-disclosure policy? Many hospitals follow so-called deny-and-defend policies regarding medical errors, thereby disclosing only limited information to patients and avoiding any admission of guilt. Physicians also receive formal training in how to disclose medical errors so that they do not provide certain information to their patients.

Are there any recent changes in disclosure policies? Yes, the recent trend is to adopt a communication-and-response model. This involves fully disclosing that a medical error occurred, making a quick apology and offering financial compensation. This proactive approach shows more respect for patients, and it has actually led to fewer medical malpractice cases being filed against errant doctors and hospitals. However, implementing such a process can be complex, considering the conflicting interests of the doctors and patients involved. To be effective, any disclosure process must be implemented with a pragmatic and sensitive approach.

Source: AHRQ.gov, "Error Disclosure," Accessed on Dec. 19, 2014

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