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Member Research and Reports

Member Research and Reports

Georgia State: Primary Care Doctors Reluctant to Discuss Errors with Patients

While most primary care physicians would provide some information about a medical error, only a minority would fully disclose important information about potentially harmful medical errors to patients, a recent survey shows.

Most of the nearly 300 primary care physicians would provide only partial disclosure of a medical error for two hypothetical cases involving cancer diagnoses they were asked to evaluate. Most would offer only a limited or no apology, limited or no explanation and limited or no information about the cause. The researchers report disclosure by physicians in this study falls short of patient expectations and national guidelines. The findings are published in the journal BMJ Quality and Safety.

douglas roblin

The purpose of this study was to examine the extent to which primary care physicians’ perceptions of event-level, physician-level, and organization-level factors influence their intent to disclose a medical error in challenging situations. The strongest predictors of disclosure were perceived personal responsibility, perceived seriousness of the event, and perceived value of patient-centered communication.

“The intent to disclose was not as frequent as we thought it might be,” said Dr. Douglas Roblin, professor in the division of health management and policy in the School of Public Health at Georgia State University and researcher at the Center for Clinical and Outcomes Research at Kaiser Permanente Georgia. “The two vignettes gave pretty consistent findings. The majority would not fully disclose, and we were hoping for full disclosure because that is the ethical expectation.”

An absent or poor response by clinicians can make a bad situation much worse, while full disclosure could lessen the negative impact. Understanding the factors affecting providers’ tendency to disclose is important to developing effective interventions to improve physician-patient communication.

Participants in this study were primary care physicians from three integrated health care delivery systems in Washington, Massachusetts, and Georgia, which were part of the HMO Cancer Research Network’s Cancer Communication Research Center.

Collaborators for the study include lead author Dr. Kathleen Mazor of the Meyers Primary Care Institute in Worcester, MA, and University of Massachusetts Medical School; Ms. Sarah M. Greene of the Health Care Systems Research Network; Dr. Hassan Fouayzi of the Meyers Primary Care Institute in Worcester, MA, and University of Massachusetts Medical School; and Dr. Thomas H. Gallagher of the department of medicine at University of Washington in Seattle.

To learn more about the study, go to http://news.gsu.edu/2016/11/28/many-primary-care-doctors-reluctant-talk-medical-errors-georgia-state-study-finds/