Testimony on Massachusetts Legislation Allowing Clinicians to Apologize for Errors

The Massachusetts Legislature held hearings today on the Healthcare Transparency bill. Here is my testimony on a provision allowing clinicians to apologize for errors without worrying that the apology could be used against them in a lawsuit.

Thank you for the opportunity to speak.

I’m Ken Farbstein. As a consultant, I helped my multi-hospital system client win the $25,000 Premier award in hospital medication safety. I'm a father and husband, and have seen my father-in-law die from a fatal medical error, which was easily preventable. I coach patient advocates in my own business. I've documented 250 stories of medical errors, all preventable, on my blog, PatientSafetyBlog.com

I strongly support this bill. I'll focus on the provision that allows doctors and nurses to apologize for an error.

There are 4 reasons why it's vital to encourage apologies by doctors and nurses.

First, apologies will allow openness that will ultimately result in better understanding of how to prevent similar errors. Now, it's taboo to talk about errors, so they're hidden and doctors and nurses can't learn from them. They're ashamed, and they can be sued and fired, for admitting an error, so they don't. And they don't tell their colleagues how to prevent those errors. So other doctors and nurses make the same errors, with the same tragic results.

Second, allowing apologies will allow the victims of medical error to regain their trust in doctors and nurses. In the stories I hear from medical error victims, they often say that the lack of any apology adds insult to injury. It destroys their trust in their doctors and nurses. And they have to depend on doctors and nurses for the rest of their lives! It’s terrifying for a patient to know the doctor or nurse made an error, and won't admit it – it makes the patient think the same thing will happen again. Over and over we hear, "No one took responsibility!"

Third, apologies will help heal the "second victim" of the error – the clinician himself or herself. We can harness the energy from the shame and self-loathing that doctors and nurses feel, and use that to fuel their work in improving the treatment system. That's what we did at CareGroup; we got providers talking about their errors – that was crucial. Allowing doctors and nurses to apologize lets them take a step in that direction.

Fourth, apologies can cut healthcare costs. The lack of an apology is often the straw that breaks the camel's back, and motivates a victim to become a plaintiff in a medical malpractice suit. With genuine apologies, patients will feel less aggrieved, and less likely to sue their doctors and nurses. There may be lower malpractice payouts, and the savings could ripple through to patients and payers.

In conclusion, these apologies by doctors and nurses will reduce future similar errors, rebuild the trust of victims, help heal ashamed doctors and nurses, and may reduce costs.

Please ensure that this bill keeps this vital provision that lets doctors and nurses apologize without fear that the apology will be used against them in a lawsuit.