Did Your Hospital Ever Apologize to You?

The January 9, 2010 New York Times has an article, “Is ‘Sorry’ the Hardest Word in Health Care?” points out that hospitals and drug makers used to make public apologies when things went wrong such as an incorrect medical procedure or a fatal dose of medicine. But over the past few years there has been an absence of any admission of wrongdoing.

But the bigger issue may be in the choice of words used after an error has been made.

From the article:

“Does working for a hospital or a drug maker mean never having to say you’re sorry? Even a decade ago, according to physicians, it was standard practice for many doctors and hospitals not to inform patients about medical errors. Now an increasing number of leading medical centers are taking a different tack and encouraging doctors to apologize to patients for mistakes and to explain what went wrong.  Doctors say that such accountability can help patients feel more cared for and empowered, as well as enhance the reputation of the doctor and medical center as honest brokers.”

Or maybe it can all be blamed on the lawyers:

“Apologizing isn’t popular among drug makers, however. And in our litigious country, C.E.O.’s are understandably gun-shy about teeing up a costly lawsuit by issuing an apology that a court might later construe as an admission of guilt. So even though two leading drug makers last year paid massive fines to settle charges that they had illegally marketed certain drugs for unapproved uses, they did not use the word “apologize” in their public statements.”

Here is how two companies provided their statements:

“Eli Lilly pleaded guilty to a misdemeanor and paid $1.41 billion to settle criminal and civil charges that it improperly marketed an antipsychotic drug for elderly patients with dementia, potentially putting them at risk. After its settlement, Lilly issued a press release saying, “We deeply regret the past actions covered by the misdemeanor plea.” (In response to a reporter’s query, Marni Lemons, a spokeswoman for Lilly, said, “We think that is an apology.”)

Pfizer paid $2.3 billion to settle criminal and civil charges that it had illegally marketed an anti-inflammatory drug and other products. Similarly, Pfizer’s statement said, “We regret certain actions taken in the past.” (Christopher Loder, a Pfizer spokesman, said last week, “We have publicly acknowledged our conduct and taken full responsibility.”)

The word “regret” just does not cut it as stated here:

“A company that openly apologizes does more than merely take public responsibility for its actions — it also signals to its own employees that certain practices are unacceptable, analysts say. And, they add, a company expressing regret may not be accepting blame. After all, you can regret an event, like an earthquake or a hurricane, in which you played no role.  “Companies use ‘regret’ as a way of avoiding accountability,” said Dr. Carl Elliott, a professor at the Center for Bioethics at the University of Minnesota. “You regret something that happened, not something that you did.”

But it all comes down to the apology may be a good thing for not only the company, but the employees of the company as now they have a role model:

“Openly apologizing also has the potential to turn a problem into a teachable moment for employees, thereby preventing a repeat occurrence, says Paul Levy, the chief executive of Beth Israel Deaconess Medical Center in Boston. In 2008, a surgeon at his hospital mistakenly operated on the wrong side of a patient. The doctor and other hospital personnel apologized. The medical profession, he says, was initially hesitant to embrace contrition. But, he says, “as in any field, once you have a few leaders do it and the world doesn’t end and, in fact, is made better, then people tend to follow.”

Read the New York Times January 10, 2010 article “Is ‘Sorry’ the Hardest Word in Health Care?”