Majority of PCPs Prefer Not to Fully Disclose Medical Errors

According to a press release on a survey published in BMJ Quality and Safety, only a small number of primary care physicians would fully disclose important information about potentially harmful medical errors to their patients.

The survey found that most of the 300 primary care physicians in the survey would only provide partial disclosure of a medical error in two hypothetical cases involving cancer diagnoses. The majority would offer only a limited apology or none, limited or no explanation and limited or no information about the cause of the error.

The purpose of this study was to examine the extent to which primary care physicians’ perceptions of event-level, physician-level and organization-level factors influence their intent to disclose a medical error in challenging situations. The researchers determined that the strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event and perceived value of patient-centered communication.

The participants of the study were primary care physicians from three integrated healthcare delivery systems in Washington, Massachusetts and Georgia—all part of the HMO Cancer Research Network’s Cancer Communication Research Center. Approximately 71% of respondents had been practicing longer than 10 years, 55.6% struggled with the demands of their practice and 36.7% contemplated leaving their practice.

The study researchers noted that the physicians’ level of disclosure fell short of both patient expectations and national guidelines. For nearly a decade, full disclosure of harmful errors to patients, including a statement of regret, an explanation, acceptance of responsibility and commitment to prevent recurrences, has been the standard for physicians in the United States.

In order to make meaningful progress toward improving disclosure to patients, physicians, as well as risk managers, organizational leaders, professional organizations and accreditation bodies, need to better understand the factors that influence disclosure.

Dr Douglas Roblin, professor in the Division of Health Management and Policy in the School of Public Health at Georgia State University and a researcher at the Center for Clinical and Outcomes Research at Kaiser Permanente Georgia, said in a statement, “The intent to disclose was not as frequent as we thought it might be. The two vignettes gave pretty consistent findings. The majority would not fully disclose, and we were hoping for full disclosure because that is the ethical expectation.”