In this week's Scrubbing Up, medical law experts Dr Anthea Martin and Dr Gail Gilmartin tell doctors that if something has gone wrong, most of the time patients just want a simple apology.
Here are some of the comments you have been sending in to this week's
Doctors must say sorry not say it's an error. We need to know why it is an error, what are they are going to do about it, and what's more it's put right to the patient's satisfaction. For example, if you are told to wait three to four months for a procedure and then find out it is a year's wait, to say it was an error is not sufficient. Otherwise patients will never trust doctors again, and this is what is happening. No doctor should ever destroy a patient's trust.
Ann Sawford, Whitstable
I was treated really badly by a GP, and nearly didn't complain, despite being really upset by it, as I didn't think anything would happen even if I did complain. I decided to do so in the end, because I thought that other patients might be subjected to the same bad manners and lack of professionalism that I was, and that it could help to remedy the situation. An apology would be nice though.
Anon, East Midlands, UK
At a time of great stress I was once prescribed blood pressure medication, without a 24-hour check. The result was I began to have dizzy spells. A check then showed my blood pressure to be too low, so my GP took me off the medication immediately. Within 48-hours I was in hospital with palpitations and a young doctor said that I should have bean weaned of the medication in question. He was immdiately pulled to one side by another doctor. When I raised the issue with him later, he had changed his opinion. A check of the manufacturer's recommendation revealed that the young doctor's initial opinion was correct. When I discussed this with my GP I was just met with silence. I was never intending to sue, I had suffered no lasting damage, so had nothing to sue for. What I wanted was the comfort of a reasonable explanation from the professionals as to why I'd had the palpiations, thus putting my mind at rest that they had not been caused by anything more serious, but the doctors closed ranks. It's not a helpful attitude.
This is definitely true with my family. When my mother had her hysterectomy, she fell victim to several examples of malpractice. My parents took action, but from the beginning preferred to receive an apology, as apologies cost nothing and don't result in money available for other patients being reduced.
Graeme Phillips, Northfleet, UK
Our GP mis-diagnosed a relatively minor condition with our new-born daughter. Whilst far from life-threatening, this caused us and our daughter over 12 months of difficulties. We complained to the practice and a meeting was set up with both the GP and the practice manager. Once all the details were 'on the table' to our great surprise, the doctor admitted that he was at fault and that he had been wrong. He apologised unreservedly.
We never had any financial interest in this matter and it was too late to change things for our precious daughter - we just didn't want him to make the same mistake with someone else's child. We think we achieved that. Doctors are human, they will make mistakes - we all do, even me! When someone can make a mistake and then hold their hands up and admit it, I for one have a lot more respect for them.
As a trainee surgeon I think 'sorry' is also a complicated word. Sometimes patients take it as an admission of guilt or of having made a mistake when it is merely meant empathetically when a known complication or adverse outcome has occurred. I am personally careful about how I word my 'sorrys' but would like to think that I am open and empathetic with patients as well as have their best interests at heart.
WB, Dronfield, UK
I am currently a medical student. The threat of medico-legal action seems to have become an ongoing joke in medical schools, where the process of being prosecuted is inevitable. It is a sad fact that we are trained to fulfill tasks and procedures with such efficiency in order to protect ourselves, as opposed to, what I believe should be the main drive for any doctor, doing it for the greater good and health of the patient in question. The growth of this suing culture, spreading from across the pond in the States, is alarming. I have not started practising yet, but my greatest fear is failing to stop a resolvable death. I hope it never occurs, but I feel the guilt would be punishment enough. As far as an apology goes, I would not hesitate.
There needs to be more clarity about "A meaningful apology requires a sincere expression of regret but more than that it requires an acknowledgment of responsibility for the harm caused". Most doctors are now taught by our legal representatives and most hospital trusts that an apology and an admission of failure are two separate things. There are many occasions where both should go hand in hand but there are situations where it is important to let the patient or family know you are deeply sorry about the situation they find themselves in but without accepting blame. Sometimes the conditions themselves are not treatable, sometimes the mistakes are not yours and sometimes the family's perception of the incident is wrong. Should we not say "I am sorry for this" in these situations? These things need to be addressed separately but not every apology is accompanied by personal blame.
Dr David Wright, Liverpool
I think that there should be a legally binding statement available which harmed patients or their families could sign, saying that they will not sue for damages. Then a doctor explaining and apologising will know that the information will not be used to harm them financially or emotionally. Surely this will clarify the situation at the outset. It would seem obvious that this would hugely increase the explanations and apologies from the medics.
Neville Cramer, Cambridge, Cambs