Study reveals complexities of disclosing and compensating for medical mistakes

When disclosing a medical error to patients, health care providers should follow up with a proactive offer of compensation—but patients’ responses may not be as straightforward as they might expect. According to a study by Harvard School of Public Health (HSPH) researchers and colleagues, two-thirds of patients expect compensation following a harmful medical error, and three-quarters are likely to accept even modest compensation offers. But offering full compensation can prompt suspicion that the provider is motivated by a desire to avoid a lawsuit, rather than a desire to do the right thing. To preserve trust in physicians, the authors recommend clearly separating disclosure and compensation discussions and leaving physicians out of talks about money.

In the December 3, 2012 study in Health Affairs, senior author Michelle Mello, professor of law and public health at HSPH, and her co-authors used experimental survey methods and hypothetical medical-error vignettes to assess people’s reactions to different types of compensation offers made in “disclosure-and-resolution” programs. Several hospital systems have adopted the disclosure-and-resolution method—in which the patient and family is informed of an unanticipated or adverse outcome, offered an apology and, when appropriate, offered compensation without having to sue. The approach is seen as a way to reduce malpractice costs and respond empathetically to injured patients.

Read the Health Affairs abstract