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Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
The Effects of Telling Patients about Medical Errors
16 March 2004 | Volume 140 Issue 6 | Page I-17
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full report titled "Health Plan Members' Views about Disclosure of Medical Errors." It is in the 16 March 2004 issue of Annals of Internal Medicine (volume 140, pages 409-418). The authors are K.M. Mazor, S.R. Simon, R.A. Yood, B.C. Martinson, M.J. Gunter, G.W. Reed, and J.H. Gurwitz.
What is the question and what is known about it so far?
Medical errors commonly occur in patient care and have received increasing attention by both the medical profession and the public. While it is unrealistic to expect that all medical errors can be prevented, doctors and ethicists agree that at the very least, patients should be informed when an error has occurred. But in practice, this information is often not communicated to the patient. Little is known about the effect of telling (or not telling) patients and their families about medical errors.
Why did the researchers do this particular study?
To find out how the disclosure of information about medical errors affects relationships between doctor and patient.
Who was studied?
958 members of a health maintenance organization (HMO) who answered a mailed questionnaire.
How was the study done?
The researchers developed a questionnaire evaluating how people responded to information that they received about the occurrence of a medical error. First, a short description of the facts and outcome of an error was presented along with a description of what the doctor said. The type of error, severity of its outcome, and completeness of the doctor's explanation varied in each description. Only 1 clinical story was presented to each study participant. They were asked to imagine themselves as the patient or the patient's family as they answered several questions about how the doctor's presentation would have affected their relationship to the doctor. The questions tried to determine whether the doctor's explanation would have prompted the patient to switch care to another doctor or seek legal advice, whether they would have been satisfied with the explanation, whether it would have changed the patient's level of trust in the doctor, and what their emotional response to the explanation would have been.
What did the researchers find?
Telling the whole story was associated with better ratings of the doctor with regard to satisfaction, trust, and the patient's emotional response. Greater severity of outcome and less complete explanations were associated with an increased likelihood that the patient would want to change doctors. However, the relationship between these factors and the likelihood of being sued was complex, and telling the whole truth did not necessarily prevent legal action. On the other hand, telling the whole truth did not increase the likelihood of being sued.
What are the limitations of the study?
Fictional cases may not accurately predict how a patient would react to a real situation. Furthermore, more than 90% of study participants were white and were somewhat more educated than the whole population. As a result, the findings may not have been accurate for people who were not members of this HMO.
What are the implications of the study?
Truthful and complete description of medical errors improves the way patients feel about the doctor but may not prevent legal action.
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