Is saying you're sorry really the best policy?

When an adverse event occurs-one in which there is "a clear-cut and objectively noted error"-then it is entirely appropriate to disclose the mistake and offer an apology to the patient, argues Medical Protective Co.'s Kathleen Roman in Medical Liability Monitor (9/2005). But offering an apology for any error that occurs isn't always necessary and may not spare you from facing litigation.

Physicians may feel that, as "captains-of-the-ship," they should take full responsibility for any adverse outcome. This is erroneous thinking, according to Ms. Roman, since errors can occur despite good care or because of factors beyond the physician's control such as patient noncompliance or delayed lab results.

In these instances, the physician can express empathy without offering an apology. For example, a physician could say, "Remember when we talked about some of the risks that can't be anticipated or prevented? Well, this is one of those instances. But there are several actions that we're going to take to help you, and we'll talk about them and answer your questions so that you are aware of what we are doing." This approach shows sensitivity and responsiveness to the patient, without being apologetic.