Knowing what is the right thing to do and research supporting the wisdom of doing it still haven’t moved a lot of practitioners who commit medical errors to respond as they should.
The results of a survey conducted by ProPublica, the consumer investigative news site, are pretty well summed up in its headline: “The Two Things That Rarely Happen After a Medical Mistake.” Patients, the story says, seldom are told or get an apology when they are harmed from medical care. Little wonder that they turn to a medical malpractice lawyer to try to figure out what happened.
The study examined responses of 236 patients who completed ProPublica’s Patient Harm Questionnaire during a one-year period, and who agreed to share their experiences. The study was led by Dr. Marty Makary, professor of surgery at the Johns Hopkins University School of Medicine, and was published last month by the Journal of Patient Safety.
Why do we still have to report that this survey, like so many stories told in court when harmed patients seek redress for medical mistakes, showed that patients who suffer injuries, infections or mistakes during medical care rarely get an acknowledgment or apology?
- It was common for health-care providers to withhold information about medical mistakes. Only 9 in 100 respondents said the medical facility voluntarily disclosed the harm.
- When officials did disclose harm, often it was because they were forced to. Nine in 100 respondents said the harm was acknowledged only under pressure.
- Apologies were infrequent. Only 11 in 100 patients or their family members reported getting an apology from a provider.
- More than 3 in 10 reported paying bills related to the harm. The average cost: $14,024.
According to ProPublica, another study in the Journal of Patient Safety estimated that at least 210,000 and maybe as many as 440,000 U.S. hospital patients a year die from medical mistakes. (See our blog, “Protecting Yourself from the Thousand-a-Day Toll of Medical Error.”)
The researchers for the more recent survey suggested that clinicians might see the need to be more honest with patients about the adverse effects of their treatment, but might lack the “moral courage” to do it. As we’ve blogged repeatedly, such acknowledgments go a long way toward heading off litigation and improving patient care.
The researchers said that patient advocates and providers should work together on how to best inform patients, and that medical schools and training programs can introduce the needed skills. Again. This is not a new prescription for correction, so why isn’t the message getting through?
Because the study’s findings come from a self-selected sample of patients, it can’t be considered hard science from which definitive conclusions about patient harm or disclosure can be made. But, really, isn’t there just a whole lot of common sense here?