Disclosure of medical errors: what factors influence how patients respond
Meyers Primary Care Institute
*Attitude to Health; Health Maintenance Organizations; Humans; Malpractice; Massachusetts; *Medical Errors; *Patient Satisfaction; *Physician-Patient Relations; *Truth Disclosure; Video Recording
Health Services Research | Life Sciences | Medicine and Health Sciences
BACKGROUND: Disclosure of medical errors is encouraged, but research on how patients respond to specific practices is limited.
OBJECTIVE: This study sought to determine whether full disclosure, an existing positive physician-patient relationship, an offer to waive associated costs, and the severity of the clinical outcome influenced patients' responses to medical errors.
PARTICIPANTS: Four hundred and seven health plan members participated in a randomized experiment in which they viewed video depictions of medical error and disclosure.
DESIGN: Subjects were randomly assigned to experimental condition. Conditions varied in type of medication error, level of disclosure, reference to a prior positive physician-patient relationship, an offer to waive costs, and clinical outcome.
MEASURES: Self-reported likelihood of changing physicians and of seeking legal advice; satisfaction, trust, and emotional response.
RESULTS: Nondisclosure increased the likelihood of changing physicians, and reduced satisfaction and trust in both error conditions. Nondisclosure increased the likelihood of seeking legal advice and was associated with a more negative emotional response in the missed allergy error condition, but did not have a statistically significant impact on seeking legal advice or emotional response in the monitoring error condition. Neither the existence of a positive relationship nor an offer to waive costs had a statistically significant impact.
CONCLUSIONS: This study provides evidence that full disclosure is likely to have a positive effect or no effect on how patients respond to medical errors. The clinical outcome also influences patients' responses. The impact of an existing positive physician-patient relationship, or of waiving costs associated with the error remains uncertain.
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Citation: J Gen Intern Med. 2006 Jul;21(7):704-10. Link to article on publisher's site
DOI of Published Version
Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine
Mazor, Kathleen M.; Reed, George W.; Yood, Robert A.; Fischer, Melissa A.; Baril, Joann L.; and Gurwitz, Jerry H., "Disclosure of medical errors: what factors influence how patients respond" (2006). Open Access Articles. 1056.