When it comes to disclosing medical errors to patients, there is a gap between physicians' attitudes and their real-world experiences admitting such errors, according to a University of Iowa study.
From a survey of faculty physicians, resident physicians and medical students, researchers found that while nearly all respondents indicated that they would disclose a hypothetical error, less than half reported having disclosed an actual minor or major medical error. The survey results are published in the online version of the Journal of General Internal Medicine.
"Our goal was to learn more about clinicians' attitudes but also what they actually have, and have not, done," said the study's lead author Lauris Kaldjian, M.D., Ph.D., associate professor of internal medicine in the UI Roy J. and Lucille A. Carver College of Medicine and director of the college's Program in Biomedical Ethics and Medical Humanities. "We were interested in what factors or beliefs might be motivating physicians who are more likely to disclose errors to their patients."
Kaldjian and his colleagues received survey responses from 538 faculty physicians, resident physicians and medical students from academic medical centers in the Midwest, Mid-Atlantic and Northeast regions of the United States. Survey questions focused on respondents' attitudes toward disclosing medical errors; whether they would disclose an error from a hypothetical medical situation; and whether they had ever disclosed a real-life medical error.
Ninety-seven percent of the faculty and resident physicians indicated that they would disclose the hypothetical medical error that resulted in minor medical harm (resulting in prolonged treatment or discomfort) to a patient, and 93 percent responded that they would disclose the error if it caused major harm (disability or death) to a patient.
However, only 41 percent of faculty and resident physicians reported actually having disclosed a minor medical error, and only 5 percent responded as having disclosed a major error. Moreover, 19 percent acknowledged having made a minor medical error and not disclosing it; 4 percent indicated having made and not disclosing a major error.
Taken at face value, the responses would imply that more than half of the physicians surveyed have never made a medical error in their careers. This is striking, Kaldjian noted.
"It seems fair to assume that all of us have made at least a minor error, if not a major error, sometime in our careers," he said.
Kaldjian acknowledges biases that can influence survey data like this , for example, a respondent's reluctance to reveal information that may be embarrassing or unflattering. The point remains, however, that there appears to be a discrepancy between how physicians and trainees believe they would act when faced with a medical error situation and how they have acted when in these situations, he said.