'Culture of medicine,' not fear of malpractice, prompts physicians to withhold information about Medical errors from patients

Physicians often fail to inform patients about medical errors because of the "culture of medicine," rather than because of concerns about malpractice lawsuits, according to a study published on Monday in the Archives of Internal Medicine, the Seattle Times reports.

For the study, researchers from the University of Washington surveyed 1,404 surgeons and general practitioners in Canada, which limits medical liability and discourages malpractice lawsuits, and 1,233 surgeons and general practitioners in Washington and Missouri, two states considered to have high malpractice insurance costs.

Researchers asked survey participants to respond to specific scenarios in which they had committed medical errors. According to the study, Canadian and U.S. respondents were significantly less likely to inform patients about serious medical errors when patients were unlikely to find the mistakes on their own, and their decisions on whether to inform patients about errors were not affected by concerns about malpractice lawsuits.

More than half of respondents said that they would inform patients about adverse events but would not inform them that the problems resulted from medical errors, and only one-third said that they would apologize, the study finds.

Study authors Eric Larson, a former medical director at the UW Medical Center and current head of Group Health's Center for Health Studies, and Thomas Gallagher, a UW internal medicine physician, said that physicians learn a "culture of perfectionism" in medical school that discourages the disclosure of medical errors. Larson said, "This code of silence, this conspiracy of silence does not work for reducing errors," adding, "What we know now is it does nobody any good to bury a mistake or cover up a mistake; you can't correct what led to the mistake unless you deal with it explicitly" (Ostrom, Seattle Times, 8/17).

An abstract of the study is available online.