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Patients “less likely to sue if they receive an apology”

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29 October 2008

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More than 90% of medical professionals believe patients are less likely to sue after being the victim of a mistake if they receive an apology and explanation for the error, according to a new survey by the Medical Protection Society (MPS).

The vast majority (nearly 90%) of the 700 professionals questioned also they believed patients are more likely to complain now than five years ago. But more than 55% said what motivated people most in doing this was simply the desire for an apology and explanation.

This finding easily outstripped the percentages who felt complainants’ prime motivations were the desire for compensation (24%), to see those involved punished (11%), or to prevent the incident recurring (10%).

However, only 68% of the professionals questioned said doctors are willing to be open with patients when something goes wrong.

Dr Stephanie Bown, MPS director of communications and policy, said: “We have long encouraged medical professionals to be open with patients about their mistakes. Our reasons for this are multiple and go way beyond the fact that it can prevent formal complaints arising.

“It is nonetheless encouraging to see so many medical professionals recognising how powerful holding their hands up can be in this respect. That is because they understand that most patients who make complaints about medical errors just want to understand what happened and why.

However, she added: “The percentage who feel doctors in general are still unwilling to be open with patients is a concern. We know there is widespread and understandable fear among professionals about facing disciplinary action over errors when it is not necessarily appropriate, especially in the current climate of multiple jeopardy which means they can be punished more than once for the same mistake.

“It would be far better, in our view, if this ‘blame culture’ could be reduced and those delivering healthcare made to feel more confident about admitting errors – which we all know are inevitable – through having the assurance that these will be dealt with fairly and proportionately.”

Dr Bown said this culture of blame was perpetuating secrecy in the health sector, with practitioners covering up their own errors and those of others. This had the effect of many professionals not only being fearful of admitting mistakes to patients but avoiding discussing them with colleagues too.

She said: “The situation identified in our survey highlights how hard it can be to change a culture – a task which requires a change in attitudes, values and behaviours.

“This climate of fear compounds the emotional and psychological damage practitioners can experience through making errors in the first place, which is partly due to a lack of preparedness, caused by the scarcity of training about dealing with adverse events within the profession.”

Dr Bown added that another reason for the lack of openness with patients about mistakes was the continuing widespread belief among medical professionals that acknowledging and apologising for errors amounted to an admission of liability. The 2006 Compensation Act specifically states that this is not the case.

She concluded: “We will continue to encourage the medical profession to be more forthcoming when errors have been made. In many ways the most important justification for advocating openness is the fundamental one that everybody makes mistakes and admitting them is morally the right thing to do.”

MPS

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