Journal of General Internal Medicine

, Volume 21, Issue 7, pp 704–710

Disclosure of medical errors

What factors influence how patients respond?

Authors

    • Meyers Primary Care InstituteUniversity of Massachusetts Medical School, Fallon Foundation and Fallon Community Health Plan
    • Department of MedicineUniversity of Massachusetts Medical School
  • George W. Reed
    • Department of MedicineUniversity of Massachusetts Medical School
  • Robert A. Yood
    • Meyers Primary Care InstituteUniversity of Massachusetts Medical School, Fallon Foundation and Fallon Community Health Plan
    • Department of MedicineUniversity of Massachusetts Medical School
    • Fallon Clinic
  • Melissa A. Fischer
    • Meyers Primary Care InstituteUniversity of Massachusetts Medical School, Fallon Foundation and Fallon Community Health Plan
    • Department of MedicineUniversity of Massachusetts Medical School
  • Joann Baril
    • Meyers Primary Care InstituteUniversity of Massachusetts Medical School, Fallon Foundation and Fallon Community Health Plan
  • Jerry H. Gurwitz
    • Meyers Primary Care InstituteUniversity of Massachusetts Medical School, Fallon Foundation and Fallon Community Health Plan
    • Department of MedicineUniversity of Massachusetts Medical School
Original Articles

DOI: 10.1111/j.1525-1497.2006.00465.x

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

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.

Key words

medical errordisclosurephysician-patient relationshipcompensation and redress

Copyright information

© Society of General Internal Medicine 2006