Candor means sometimes having to say you’re sorry, but it can defuse a potentially litigious situation. That’s surgeon Michael S. Woods’ message in the new edition of his book, “Healing Words: The Power of Apology in Medicine” (published by Joint Commission Resources, 2007).
A general surgeon in Santa Fe, N.M., Dr. Woods is founder and president of the Center for Physician Leadership and a member of The Sorry Works! Coalition board of directors. He views apology as a common courtesy, not confession.
“Apology has nothing to do with causation,” he writes. “It’s about empathizing, showing concern, and being respectful” of a patient as a fellow human being. If a doctor says he’s sorry a patient is in pain or that a complication arose, he is admitting no more guilt than if he extended his condolences to a bereaved acquaintance.
Dr. Woods also advocates “transparent communication” based on frank, detailed discussions with patients about their condition. “We should be doing this because it’s right, not because it’s going to lower our liability,” he says. But a willingness to share information and to commiserate when things go wrong creates a two-part “honesty dividend.”
On the one hand, patients who believe they have received a detailed account of the course of
their treatment are less likely to visit a plaintiff lawyer. Most patients demand explanations “because they want to understand,” not be-cause they’re looking for blame, Dr. Woods asserts. They can appreciate that adverse outcomes or unexpected complications may have nothing to do with negligence or mistakes.
Secondly, “Apology and disclosure, and when appropriate offering fair compensation for any identified errors, dissipate anger, which … is the driver of medical malpractice lawsuits.” As doctors and hospitals build reputations for integrity, trial lawyers will “quickly learn that the bad outcome does not likely involve negligence and is not worth pursuing,” Dr. Woods observes.