Healthcare News & Insights

Keys to help doctors discuss adverse events with patients

If an adverse event happens, it’s important for hospital staff to communicate with patients and their families right away so they can be aware of the situation and how it’ll be resolved. However, doctors may struggle with this for several reasons, and hospitals must help them along. 

GettyImages-481073822Particularly, surgeons can have problems communicating with patients after a problem occurs post-surgery, as shown by a study in JAMA Surgery.

The study looks at exactly what surgeons are thinking when they talk with patients about serious issues that arise after their procedures, using data from surveys taken by surgeons who reported adverse events at three Veterans Affairs medical centers.

Difficult discussions

According to an article in Kaiser Health News, it’s commonly believed that doctors have trouble reporting adverse events and talking about them with patients because they’re afraid of lawsuits.

However, the study shows that a more universal reason may be holding them back: embarrassment.

Doctors may simply be ashamed and upset that the mistake happened, and they’re often more worried about how the patient will perceive them after owning up to the problem than whether they’ll be sued.

Despite this, most doctors still do disclose some information about the event. Close to 90% of those surveyed informed patients and their families about the adverse event within 24 hours. They also explained what led to the event, expressed regret for it and let patients know how they should handle any subsequent problems caused by the event.

However, doctors don’t often paint the full picture for patients and their families. Around half of those surveyed talked about whether the event was preventable, and only a third mentioned the steps the hospital would take to avoid similar events in the future.

And although most doctors expressed regret about the event, only about half of them actually apologized to the patient for the issue. Apologies are crucial because they often determine whether a patient will pursue legal action against a doctor or hospital. Saying “I’m sorry” is a simple way to head off many problems and soothe hurt feelings.

Doctors’ real fears

Doctors may be hesitant to apologize right away due to their own emotions surrounding the adverse event.

According to data from the JAMA Surgery study, surgeons who found an event very or extremely serious, and had problems talking about it, were much more likely to feel anxious about the experience.

Anxiety also increased due to fears of negative reactions from patients or damage to their professional reputation.

The same fears are likely prevalent in surgeons across the country. Doctors aren’t taught how to have sensitive conversations in medical school, so that means they may feel awkward having them, whether it’s due to similar fears or other misconceptions about how the discussion will be received.

To dispel these myths, it’s a good idea to provide doctors with specialized training for having conversations with patients about medical errors and other adverse events, including strategies for breaking bad news to patients and how to handle their response.

Per the JAMA Surgery study, it can also be helpful for facilities to acknowledge the difficulty that exists for doctors when they’re preparing to have a difficult conversation with a patient, and to provide them with the support they need after disclosing a problem, including pointing them toward resources to improve their well-being and reduce the stress caused by the conversation.

Overall, if doctors are apologetic and receptive to feedback when speaking to patients, instead of being defensive, it can go a long way toward resolving any problems that arise after an adverse event occurs during surgery.

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