Disclosure of medical errors
What factors influence how patients respond?
Received: 28 July 2005 Revised: 07 November 2005 Accepted: 21 February 2006 DOI:
Cite this article as: Mazor, K.M., Reed, G.W., Yood, R.A. et al. J Gen Intern Med (2006) 21: 704. doi:10.1111/j.1525-1497.2006.00465.x Abstract Disclosure of medical errors is encouraged, but research on how patients respond to specific practices is limited. BACKGROUND: 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. OBJECTIVE: Four hundred and seven health plan members participated in a randomized experiment in which they viewed video depictions of medical error and disclosure. PARTICIPANTS: 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. DESIGN: Self-reported likelihood of changing physicians and of seeking legal advice; satisfaction, trust, and emotional response. MEASURES: 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. RESULTS: 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. CONCLUSIONS: Key words medical error disclosure physician-patient relationship compensation and redress
None of the authors have any conflicts of interest to declare.
Prior Presentation of Results: Portions of this study were presented in a poster at the National Patient Safety Foundation Congress, Boston, May 4–7, 2004 and at the National Patient Safety Foundation Congress, Orlando, May 4–6, 2005.
Funding/Support: This study was supported by a grant from the National Patient Safety Foundation and the Commonwealth Fund (20030288).
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