Transparent communication in health care, particularly regarding disclosure and apology after a missed diagnosis or medical error, is at the forefront of patient experience discourse. In the past, many patients never met their radiologist to hear about these highly charged clinical events. Today’s patients are different. They want to hear from the radiologist. In a recent article by Radiology Business, Dr. Stephen Brown, MD confirms that “strong cultural currents are driving radiologists inexorably toward situations where we will be required to disclose our errors to patients.”
While disclosing and apologizing for a medical error can reduce a patient’s psychological distress and repair trust in their health care, there is a risk. Poorly conducted conversations can make a bad situation worse for everyone involved.
Lawrence Van Horn, PhD, MPH, MBA, co-author of a Stanford Law Review paper on disclosure law explained in a recent interview with Healio Primary Care: “…without proper training, clinicians may offer apologies in ways that ultimately increase, not decrease, their malpractice liability risk as demonstrated in our paper.”
In an article published by Diagnostic Imaging entitled 5 Tips for Radiology Error Disclosure, Tom Gallagher reiterates this same point: “When we look at disclosures that have gone wrong… [the biggest reason is] lack of planning and preparation.”
Radiologists can gain skills, competence and confidence from good training and preparation before they are unexpectedly thrust into the complex disclosure and apology process, for the patients’ benefit as well as their own.
As per an article published by the journal Radiology, co-authors, including our own Director of IPEP, Dr. Stephen Brown, conclude that: “When it comes to talking with patients about harmful errors, radiologists can no longer remain secluded in the shadows. Radiologists are now held to the same standards of communication and professionalism applied to physicians who provide direct clinical care.”
Here is a list with quick links to the articles covered in this post:
Radiologists may soon be expected to disclose errors, apologize to patients
Radiology Business, August 13, 2019
Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey
BMJ Quality and Safety Journal, Betsy Lehman Center for Patient Safety, January 20, 2020
5 Tips for Radiology Error Disclosure
Diagnostic Imaging, MJH Life Sciences, November 26, 2012
Stepping Out Further from the Shadows: Disclosure of Harmful Radiologic Errors to Patients
Radiology. 2012 Feb; 262(2): 381–386.
How to apologize effectively for medical errors
Helio Primary Care, May 14, 2019
For you | For your team | For your institution
Upcoming workshops on Disclosure and Apology
From the Institute for Professionalism and Ethical Practice.
Taught by Harvard Medical School and Boston Children’s Hospital faculty. CEs and group rates available.
March 27, 2020
The Fundamentals of Disclosure Coaching
Half-day workshop in Boston, MA
(accepting applications for waitlist only)
April 8, 2020
Disclosure and Apology in Radiology
2-hour online workshop for radiological professionals
May 27, 2020
Deep Dive into Disclosure and Apology
2-hour online workshop