Johns Hopkins Bloomberg School of Public Health LogoA novel research from the Johns Hopkins Bloomberg School of Public Health claims that when reporting medical errors, patients’ opinions of their physicians’ may possibly be crucial in gaining their trust. However, a positive perception of the disclosure seems to have little effect on the lawsuit risk a physician faces.

For the purpose of the analysis, experts examined volunteer responses to numerous videos representing the disclosure of an unfavorable event along with variations in the extent to which a physician accepted the blame.

Lead author, Albert Wu, MD, MPH, a professor with the Bloomberg School’s Department of Health Policy and Management, stated that, “Viewers were more likely to want to sue physicians that offered an incomplete apology or who did not accept responsibility. When viewers thought that the doctor had apologized and taken responsibility, they gave the doctors much higher ratings with 81 percent of viewers reporting trusting the physician and 56 percent reporting they would refer the physician. However, despite the positive reaction to perceived apology or responsibility, viewers were only slightly less inclined to want to sue.”

During the research, researchers examined 200 adult volunteers from Baltimore City videotaped vignettes which showed physicians revealing one of three adverse events to patients. Apparently, the vignettes varied in the extent of their apology and acceptance of responsibility. Viewers were then asked to evaluate the physicians.

In addition, actors were believed to have been used in order to form the adverse events. The events included were noted to be one year extensive delay in detecting a malignant-looking lesion on a mammogram, overdose of chemotherapy ten times the required amount and a slow response to pages by a pediatric surgeon for a patient who ultimately collapses and is rushed to emergency surgery. Besides, apology variations were observed to be full, non-specific and none, while blame variation was limited to full and none.

“There is broad consensus that physicians and health care organizations should disclose adverse events to patients and their families. Our findings show that the perception of what is said is more strongly associated with how physicians were perceived. Training is needed to help those in practice and training carry out the difficult task of disclosing adverse events. Moving forward, it will be important to evaluate the effectiveness of that training, including how it is perceived by patients and their families,” says Peter Pronovost, MD, PhD, a co-author and professor with the Bloomberg School’s Department of Health Policy and Management and the Johns Hopkins School of Medicine.

Wu along with colleagues from the Johns Hopkins School of Medicine and the University of Florida further examined the relationship between the intended and perceived variations to responses. Supposedly, these variations were examined in order to account for differences in viewer demographic characteristics.

The findings revealed that a patient’s view of what was said seems to have been more important in contrast to what was actually said by the physician. Additionally, researchers found that a complete apology and acceptance of blame by the physician in error apparently associates with improved ratings and greater trust.

The findings have been published in the Journal of General Internal Medicine.