Disclosure of medical errors
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BACKGROUND: Disclosure of medical errors is encouraged, but research on how patients respond to specific practices is limited.
OBJECTIVE: This study sought to determine whether full disclosure, an existing positive physician-patient relationship, an offer to waive associated costs, and the severity of the clinical outcome influenced patients’ responses to medical errors.
PARTICIPANTS: Four hundred and seven health plan members participated in a randomized experiment in which they viewed video depictions of medical error and disclosure.
DESIGN: Subjects were randomly assigned to experimental condition. Conditions varied in type of medication error, level of disclosure, reference to a prior positive physician-patient relationship, an offer to waive costs, and clinical outcome.
MEASURES: Self-reported likelihood of changing physicians and of seeking legal advice; satisfaction, trust, and emotional response.
RESULTS: Nondisclosure increased the likelihood of changing physicians, and reduced satisfaction and trust in both error conditions. Nondisclosure increased the likelihood of seeking legal advice and was associated with a more negative emotional response in the missed allergy error condition, but did not have a statistically significant impact on seeking legal advice or emotional response in the monitoring error condition. Neither the existence of a positive relationship nor an offer to waive costs had a statistically significant impact.
CONCLUSIONS: This study provides evidence that full disclosure is likely to have a positive effect or no effect on how patients respond to medical errors. The clinical outcome also influences patients’ responses. The impact of an existing positive physician-patient relationship, or of waiving costs associated with the error remains uncertain.
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- Disclosure of medical errors
Journal of General Internal Medicine
Volume 21, Issue 7 , pp 704-710
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- medical error
- physician-patient relationship
- compensation and redress
- Industry Sectors
- Author Affiliations
- 1. Meyers Primary Care Institute, University of Massachusetts Medical School, Fallon Foundation and Fallon Community Health Plan, Worcester, MA, USA
- 2. Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- 3. Fallon Clinic, Worcester, MA, USA