education. A facility-specific apology and disclosure program is much
different than a surgeon making a decision to apologize on his own.
In the future, we might see more legislative action to encourage facili-
ties to create these types of programs. The Agency for Healthcare
Research and Quality has a "CANDOR" toolkit (osmag.net/A7JTjd)
that serves as a guide for what to do after an adverse event. It may
provide a good starting point for states and facilities that are looking
to go beyond their apology laws.
The hardest word
I'm not writing about whether you should apologize from an ethical per-
spective. If you've made a mistake that affects a patient and their fami-
ly, you should expect some consequences. The moral component of a
medical apology is a whole other question to consider. But from a legal
perspective, if you don't have any training, you should be careful and
know the risks. Even in states with apology laws, a poorly worded "I'm
sorry" can have serious consequences. After all this time, we've learned
a simple "sorry" will not make a medical mistake go away.
OSM
Dr. McMichael (bmcmichael@law.ua.edu) is an assistant professor at the
Hugh F. Culverhouse Jr. School of Law in Tuscaloosa, Ala.
J U N E 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 0 1
Here's what patients are look-
ing for when you disclose mis-
takes in their care:
1. Disclosure of all harmful
errors
2. An explanation as to why the
error occurred
3. How the error's effects will
be minimized
4. Steps the physician (and
organization) will take to pre-
vent recurrences
SOURCE: Agency for
Healthcare Research
What Patients Want to Hear
SORRY TIME