Majority of primary-care physicians would not fully disclose harmful medical errors, study shows

Only a minority of primary-care physicians would fully disclose important information about potentially harmful medical errors to patients, a U.S. survey has shown.Published in BMJ Quality and Safety, the study involved primary-care physicians from three integrated health-care delivery systems in Washington, Massachusetts and Georgia. A total of 297 out of 630 physicians responded to the survey and were included in the analysis.The survey presented two hypothetical vignettes: (1) delayed diagnosis of breast cancer, and (2) care co-ordination breakdown causing a delayed response to patient symptoms. In both cases, multiple physicians shared responsibility for the error, and both involved oncology diagnoses.The majority of respondents would not fully disclose a harmful medical error in either situation, providing only a limited or no apology, limited or no explanation and limited or no information about the cause.When asked what they would tell the patient about the cause of the error, 77% of physicians for the case involving delayed diagnosis of cancer and 58% of physicians for the case involving a care co-ordination breakdown would offer either no information or make vague references to miscommunications. In both cases, more than half would not volunteer an apology or would offer only a vague expression of regret.Physicians would be more forthcoming in the care co-ordination breakdown than for the delayed cancer diagnosis, but most would provide only partial disclosure after either of the events.In contrast to these responses, the researches pointed out that the current standard of care is full disclosure of harmful errors to patients, including a statement of regret, an explanation, acceptance of responsibility and commitment to prevent recurrences.In the study, the strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event and perceived value of patient-centred communication.The majority of respondents (71%) had been in practice for more than 10 years; nearly 56% indicated they often questioned whether the demand of their practice was worth the toll, and almost 37% often thought about leaving practice.The study was led by Dr. Kathleen Mazor (EdD), a professor of medicine at the University of Massachusetts medical school and associate director of the Meyers Primary Care Institute in Worcester, Mass.

Majority of primary-care physicians would not fully disclose harmful medical errors, study shows

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