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Why An Apology Matters In Medicine

Discussion in 'Hospital' started by The Good Doctor, Apr 5, 2023.

  1. The Good Doctor

    The Good Doctor Golden Member

    Aug 12, 2020
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    March was Endometriosis Awareness Month, and my journey with the disease involved a medical error. The apology I received restored trust in my care, a pivotal moment I hope can occur between more patients and physicians.

    Medical error disclosure to patients, where a medical professional reports and explains a medical mistake to a patient, is encouraged by the Joint Commission on Accreditation of Healthcare Organizations. However, the process of disclosing a medical error and the physician-perceived benefit to patients varies. Although I work in health care, I was unaware of my rights to discuss a medical error as a patient, and how important a medical apology was, until I faced the issue myself.

    In the summer of 2022, I endured unbearable pain when menstruating. While I had experienced similar pain episodes in the past, the progression never lasted beyond a day.

    My primary care physician at Rush University referred me to get ultrasounds completed, and the source was clear. I had an endometrioma the size of a tennis ball on my left ovary. The cyst was large enough to potentially twist the ovary and tilt my uterus. Each menstrual cycle I had, the cyst was hemorrhaging and growing.


    Two physicians, a resident and an attending, signed off on the summary of the ultrasound scans. My gynecologist swiftly prepared me for surgery after a week-long debilitating pain episode in December landed me in the emergency room. My surgery was scheduled for the end of January 2023, and I was hurriedly planning everything I needed, from pre-op requirements to submitting days off from work.

    Everything changed the day of my pre-op appointment, two weeks before my surgery date. I was reviewing my second set of scans, and a different imaging physician noted that my cyst originally measured one-third of the size the two previous physicians reported. Surgery is not recommended for a mass that small. A review of the original scans confirmed the measurement error. A total of three physicians had missed the error, and my gynecologist casually said that “there must have been a typo” on my first scan.

    A month’s worth of preparation, anxiety, disclosure, and limitations was suddenly nullified. The opportunity cost of everything I turned down while waiting for surgery weighed on me. I almost received unnecessary surgery, a near miss. While discussing with my gynecologist, I switched from pre-op questions to the next steps, grateful that the error was caught.

    My emotions didn’t hit until I left my appointment. On the walk back to my office, I instantly regretted not asking how this mistake would be handled. Would the physicians get feedback? How often does this happen? Why was this error treated nonchalantly?

    I wanted acknowledgment that my medical error had consequences. I understood that medical errors were common and often unknown by patients, but I saw and experienced this mistake. I hadn’t received any indication that my medical file would be corrected.

    Embarrassingly confused about what to do next, I trusted my boss with the information, and she advised me to contact patient services at the hospital. I did not know hospitals had such a department, and I have been working in academic medicine for five years. I sent an email detailing the error, not knowing how long it would take to get a response.

    Asking for an apology felt futile, but that is what I needed most. My request was two-fold: Correct the error in my first set of scans, noting that a mistake was made, and have a physician (I honestly didn’t care which one) apologize for the error.

    To my surprise, my email was handled within a week. I received confirmation of my report, and a patient safety officer reached out shortly after. I would have settled for a simple email or call, but one of the physicians who interpreted my first set of scans met me in person. It was an emotional 15 minutes.

    The physician apologized, thanked me for the feedback, and took me through the plan to prevent this type of error from happening again. They explained that the error happened during medical transcription when the AI platform failed to match the physician’s dictation. They acknowledged that this oversight directly impacted the direction of my care. Validating the significance of the error and seeing me as a person, rather than a medical record number, meant the world to me. Seeing the physician likewise placed a face, showing sympathy, to a name I previously did not know prior to the error. We spoke about my current treatment, how I was feeling, and ended the conversation with mutual thanks for our time.

    Apology laws in medicine seek to legally protect apologizing physicians from malpractice claims to increase transparency between physicians and patients. While different approaches to apologizing can help or harm the physician-patient relationship, I know firsthand that a thoughtful, full apology can do more than comfort; it can repair.

    Being seen meant I could move forward and close this experience behind me. It not only restored my trust in my own medical care, but the hospital itself that I represented. I am unsure if my privilege of being an employee facilitated the speed and care with which I received an apology, but I hope it did not. Every patient deserves to feel seen in their care, and medical apologies are one way to get there.


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