22 Aug 2014

Why sorry can be the hardest word for doctors

Sorry. It is such a hard word to say. I know because I have a five-year-old and whenever I ask her to apologise for some misdemeanour the most I generally get is a muttered, begrudging apology with body language that says in reality, “No, I’m bloody not sorry but I know if I don’t say it I may get in bigger trouble.”

And so my thoughts turn to the General Medical Council and their proposals that doctors should be make to apologise if they have been found to have done something wrong.  Out to consultation, the idea is that if they have said sorry it will be taken into account when the sanctions are being decided upon.

It is a good idea in principle because over the years I have met numerous patients or their families who would have loved nothing more than to hear the doctor say sorry.  I don’t like the word but it does help with closure.

Yet I am absolutely certain that an apology made because the doctor fears being struck off the medical register would not make the family feel better at all.  It would, indeed, have as much sincerity as my five-year-old thinking she’s not going to get her ice-cream unless she does what she is told.

I am also certain that there are many doctors who would gladly have apologised when a mistake has been made but who will have been told by their management or their lawyers that they should do no such thing.

In fact, I once met a wonderful consultant who had gone out of her way – and against the express wishes of her trust – to apologise to the distraught parents of a baby who had died.  The only problem was she had not actually done anything wrong.  She had tried to save the baby who had been harmed by others.

We know, too,  from what happened at Mid-Staffordshire and from all the evidence from whistleblowers, that the NHS will often go to great lengths to avoid admitting a mistake because they fear the outcome: reputational damage or being sued.

That, in turn, encourages a climate in which the word “sorry” is verboten.  It must be the case, though, that when a trust is prepared to admit errors then they are also prepared to learn from them and that can only be good for the safety of patients.

And if a doctor (or nurse) works in that environment then they are going to feel much easier about owning up when something has happened.

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