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Sorry shouldn’t be the hardest word for doctors

Generally speaking, patients who suffer clinical negligence at the hands of a medical professional tend to sue for one of two reasons. Either the mistake is likely to cost a large amount of money to rectify or manage, or somewhere along the way the bedside manner went wrong.

From a patient’s point of view, the first is understandable. When a baby is born with brain damage through a mistake in practice or a mistake occurs during surgery, it can be a life altering event and it’s only natural for the people involved to want recompense.

The largest six or seven-figure settlements usually fall into this category and losing large amounts of money like this quickly prompts senior management to take note and address the cause.

The second reason involves patients suing for less serious things like inadequate explanations before procedures, unexpected side effects or breakdowns in communication. As distressing as these are to the patients involved, many disputes could be resolved with a simple apology.

To help this along, the GMC is about to publish some new guidelines called the Duty of Candour, which is about how to approach issues from big to small. In essence, they are going to encourage new best practice for doctors, including apologising and explaining what has gone wrong on smaller issues, something that currently doesn’t always happen, as well as also offering advice to doctors and Trusts on the best ways of dealing with larger, more serious issues.

The Duty of Candour contains guidelines for what doctors can do to prevent issues arising in the first place. It presents a real challenge to the unwritten rule that has existed in Trusts for years that says doctors shouldn’t apologise for fear of admitting liability. The GMC is now trying to reverse this trend, advising Trusts and doctors alike that sorry shouldn’t be the hardest word.

Sometimes all that a patient wants is an apology. Without it, they often get pushed into a mindset for litigation when something goes wrong, pushing and pushing so that no one else has to go through the same thing.

However, this can be a real minefield for the healthcare profession. Trusts can’t order doctors to apologise, despite the fact that it might help to nip certain issues in the bud. While for doctors, it’s a real balancing act too. It’s really important to try and to stay on right side of the trust that is their employer (and who will ultimately pick up the bill) while at the same time staying on the right side of the patient, but in work as in life, when something goes wrong they might not feel like accepting the blame.

If it does nothing else, the Duty of Candour should at least sharpen the focus on the dilemmas facing doctors, and make them more aware of how they handle difficult situations with patients.

From a doctor’s point of view, the more serious the negligence, the more appropriate it is to quickly escalate the problem up the ranks and seek guidance on how it should be handled, while less serious examples can be nipped in the bud with a simple apology.

As with many things though, the right answer for what to do in these situations mostly comes down to decent common sense. This is very easy to say from a patient or lawyers perspective, but it’s more difficult from a doctor’s point of view.

The long held view of ‘never apologise, never explain’ has been culturally endemic in the health service for years, but there’s a lot of work being done to change that and there are ever increasing amounts of support for doctors regarding whistleblowing.

The new Duty of Candour guidelines from the GMC is the first major step forwards with assisting doctors and trusts, with the aim of an improved health service for everyone.

GMC’s consultation document on Duty of Candour guidance

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One Response to “Sorry shouldn’t be the hardest word for doctors”

  1. Anytime Doctor says:

    I’m agree with you my friend and very thoughtful about it. Sorry must not be hard word for a doctor as being a doctor you come across dealing with various type of person. A sorry is most precisely effective word which can calm even angrier. So wear a smile and don’t hesitate to utter sorry.

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