When Doctors Say, "We're Sorry"

It's easy to understand why Trish and Andy Olson initially considered suing. But more than money, what the suburban St. Paul, Minn., couple wanted from the hospital was a genuine apology. Their son Owen, 7, born with spina bifida and a range of other birth defects, had already endured more than 40 operations by the time he was taken to the Children's Hospitals and Clinics of Minnesota for treatment of a suspected infection last fall. Because the staff on duty that night forgot to attach a catheter to Owen, doctors ended up having to take emergency action several hours later, first using a needle to drain his dangerously full bladder and then, after his bowel was punctured during the procedure--a known risk--surgically repairing the damage.

Although the little boy escaped with no permanent damage, his parents' faith in the hospital was not easily restored. But then something unusual happened: the administrators and the family's doctors said they were sorry, explained how the error happened and offered to help with Owen's growing medical bills. The Olsons soon gave up thoughts of legal action. "They have been wonderful about everything," says Trish. "We were angry, but we're not anymore." Dr. Phil Kibort, the hospital's vice president of medical affairs, says, "When I went to medical school, I didn't plan on doing this. But I want [patients] to feel they can trust us."

At a time when hospitals and doctors are desperate to reduce the rising costs of malpractice insurance and litigation, apologizing for medical mistakes may seem to some like legal suicide. But to a widening coalition of players on all sides of the issue--from doctors, hospital administrators and insurance executives to patient advocates, politicians and even trial lawyers--it may actually be a step in the right direction. Since many of these players believe malpractice lawsuits are motivated as much by feelings of frustration as by the almighty dollar, in their view, honesty may indeed be the best policy.

To help encourage openness, over the past few years, such states as Florida, North Carolina, Missouri, Illinois, Colorado, Arizona and Oregon have passed bills under which a doctor's apology for a medical mistake or expression of sympathy is inadmissible in civil court. A few like Pennsylvania are even mandating the prompt, formal disclosure of any such errors to patients and state authorities. Legislation has been introduced in Congress to help set up similar pilot programs in other states, and President Bush recently signed a bill establishing a confidential and voluntary system for reporting medical errors. In addition to giving people less motivation to sue, supporters argue, fuller disclosure will help reduce malpractice in a more fundamental way by helping health-care professionals learn from mistakes so fewer preventable errors occur.