Medical Error Research Paper

Medical Error
Brenetia FFrench-Shareef
Liberty University

Medical Error
Medical error in the field of medicine is a common event. Physicians respond to such mistakes through an apology. Apology is defined as a statement that acknowledges an error together with its outcome. In such a case, healthcare providers take responsibility and express regret for causing injury. Mostly, apology is anticipated to reduce anger, blame, and at the same time enhance therapeutic relationships and increase trust. In addition, apologies are perceived as an effective approach that can prevent a medical malpractice lawsuit. Nevertheless, potential litigation is cited as the most prevalent barrier that restricts apology (Robbennolt, 2009). The intention of

this paper is to look at the aspect of ‘explanation and apology’ and the perception of the physician that such methods do not make any difference. While patients seek apology, healthcare professionals are of the view that apology can create legal liability in formal litigation. Furthermore, the essay will provide alternative methods that can resolve medical disputes between patients and professionals to attain their respective objectives.
Assessment of the Dichotomy
Communication between physicians and patients, focusing on possible medical malpractice liability, is encouraged by state apology laws.

The laws make it easier for physicians to offer apologies for medical mistakes. Healthcare providers are protected by these laws where their statements of apology are excluded from malpractice trials. However, physicians who do not work in the surgery unit feel that the apology laws expands their chances of facing a lawsuit. Additionally, the law increases the amount of money that is used to solve a dispute. From this perspective, McMichael, Van Horn, & Viscusi (2016) conducted research to assess the impact of state apology laws on the risk of medical malpractice litigation. The researchers employed distinct dataset obtained from a big national malpractice insurer. The investigation concentrated on lawsuits made against physicians for eight years, that is, from 2004 to 2011. Both claims and malpractice cases formed the foundation of the investigation. The outcome of the study indicates that the apology law is not effective because it does not influence the chances of a physician to face a claim. As a matter of fact, the law is said to increase the likelihood of a physician, who is not rated for surgery, to encounter a lawsuit by 1.2% points. This is interpreted as a 46% increase as compared to the national average. Besides, there is no evidence that apology cuts the average payment paid to a claimant by a physician (McMichael et al.,

2016).
On the other hand, Berlin (2013) contends that medical errors are solved within the professionalism framework such as disclose-apologize-compensate algorithm. The author provides evidence that confirms the effectiveness of the strategy. As stated in the report, the framework has produced favorable results; the number of malpractice suits has declined by 65%. Likewise, the strategy has led to a 70% decline in the total legal expenditure and has improved the relationship between patient and physician (Berlin, 2013).
The immense evidence discloses that health care systems, families, and patients benefit from suitable apologies and disclosure in the event of a medical error. Nonetheless, some challenges are experienced in the healthcare system, restricting the extent to which medical mistakes are disclosed. According to Monk, Sinclair, & Nelson (2016), healthcare providers do not believe that ‘apology and disclosure’ promote positive results. Mainly, healthcare professionals believe that clients lose faith in the delivery of services by the healthcare system. Most importantly, physicians fear litigation and hence fail to comply with policies that promote apology and disclosure (Monk et al., 2016). Failure to comply increases the gap between families, patients, and healthcare providers. Mainly, the obstacles to apologize are divided into two groups: legal and individual. From the individual view, physicians avoid apology because they fear to reduce their professional standing. Other reasons include the low degree of relational confidence, self-consciousness, and humiliation. On the contrary, legal issues include restriction to practice, fear of intense disapproval, as well as fearing a legal action. Also, lawyers discourage physicians from owning medical errors since it amounts to admitting liability (Monk et al., 2016). Hence, the failure of ‘disclosure and apology’ is perceived as a way in which physicians manage inadequacies, shame, and fear. Nevertheless, the behavior is associated with slow psychological and physical healing procedure for families and patients. Also, the physicians encounter a hard time overcoming the situation and, in some instances, the inability to admit errors results in stunted professional growth (Monk et al., 2016).
Similarly, Westrick & Jacob (2016) reckon that ‘error disclosure’ is a requirement set by the regulatory and ethical standards. In addition, like Westrick & Jacob (2016), McMichael et al. (2016) suggest that some states have apology laws that safeguard the statements provided by healthcare professionals acknowledging medical mistakes. Nonetheless, the idea of apology and error disclosure persists to be a concern by medical professionals because of the increased susceptibility to liability (Westrick & Jacob, 2016).
Overall, Lipira& Gallagher (2014) asserts that explaining adverse occurrences to patients, especially those that result from medical mistakes is a fundamental component of patient-centered healthcare. Additionally, a disclosure of medical mistakes lays the foundation of quality enhancement and patient safety. Despite the significance of disclosure outlined in above-mentioned articles, physicians continue to face challenges that discourage them from expressing their apology. From a biblical perspective, apology is acceptable in the event a person wrongs another. In fact, the Bible directs people to forgive one another when an apology is presented. The power of apology is highlighted in the book of Luke 17:3 that states, “Take heed to yourselves; If your brother trespasses against you, rebuke him; and if he repents, forgive him” (Bible, 2000). From this angle, it is correct to argue that the use of apology by medical officers in the event of an error is acceptable and the affected patients and families should be ready to accept it and forgive the act causing injury.
Recommendations
There is sufficient proof that confirms that physicians avoid apology because they fear litigation.

From this view, various methods can be implemented to improve the process of reporting a medical error and reducing the number of lawsuits made by patients. First, healthcare providers should ensure a stable provider-patient relationship that is attained through effective communication. Secondly, healthcare professionals should engage patients in discussions that explain the consequences of a medical therapy before subjecting an individual to the identified treatment procedure (Song et al., 2016). Alternative methods that can be used to resolve the issue of medical malpractice include training programs that make it easy for healthcare providers and family to meet following a medical error. Such programs facilitate communication of heartfelt acknowledgment by the physician. Also, the program promotes honest and open engagement between the victim and healthcare professionals. BICEPS (Brevity, Immediacy, Centrality, Expectancy, Proximity, Simplicity) model is an example of an effective framework that is utilized in healthcare institutions to resolve problems involving medical errors. The model puts more emphasis on resiliency, strength, and support, which encourage nurses, and physicians to address adverse medical occurrences (Monk et al.,

2016).  
References
Berlin, L. (2013). To disclose or not to disclose radiologic errors: should “patient-first” Supersede radiologist self-interest?.Radiology, 268(1), 4-7.
Bible, H. (2000). King James Version. Texas: National Publishing Company.
Lipira, L. E., & Gallagher, T. H. (2014). Disclosure of adverse events and errors in surgical care: Challenges and strategies for improvement. World journal of surgery, 38(7), 1614-1621.
McMichael, B. J., Van Horn, R. L., &Viscusi, W. K. (2016). Sorry is Never Enough: The Effect of State Apology Laws on Medical Malpractice Liability Risk.
Monk, G., Sinclair, S., & Nelson, M. (2016). Exploring Healthcare Professionals' Use of Narrative Mediation Approaches to Address Disclosure and Apology in the Aftermath of Medical Errors. Narrative and Conflict: Explorations in Theory and Practice, 3(1), 24-43.
Robbennolt, J. K. (2009). Apologies and medical error. Clinical orthopaedics and related research, 467(2), 376-382.
Song, D. J., Choi, J. W., Kim, K., Kim, M. S., & Moon, J. M. (2016). Quasi-Experiment Study on Effectiveness Evaluation of Health Communication Strategies. Journal of Korean Medical Science, 31(7), 1027-1036.
Westrick, S. J., & Jacob, N. (2016). Disclosure of Errors and Apology: Law and Ethics. The Journal for Nurse Practitioners, 12(2), 120-126.