How do patients want physicians to handle mistakes? A survey of internal medicine patients in an academic setting.
How do patients want physicians to handle mistakes? A survey of internal medicine patients in an academic setting.
复制标题
患者希望医生如何处理错误？
DOI：
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发表时间：
1996
影响因子：
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通讯作者：
Steven B. Hardin
中科院分区：
文献类型：
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作者：
Amy B. Witman;Deric M. Park;Steven B. Hardin
背景
错误是行医中不可避免的一部分。虽然医疗差错的频率和严重程度被记录在案，但关于患者对医生差错的态度却知之甚少。
客观化
调查患者对医生差错的态度。
设计
一项调查工具评估了对3种水平的医生错误(轻微、中度和严重)和2种基本医生反应的态度：披露或不披露。149名研究对象随机抽取自学术类全科内科门诊。
结果
几乎所有的患者(98%)都希望即使是微小的错误也能得到一些承认。患者希望转介给另一位医生的意愿从14%的人在犯了小错误后到65%的人在犯了严重错误后不等。对于中度和严重的错误，如果医生不披露错误，患者明显更有可能考虑诉讼。在中度错误情景中，12%的患者会在医生告知的情况下提起诉讼，而如果医生没有披露错误并通过其他方式发现错误，则有20%的患者会提起诉讼(P<；.001)。
结论
患者希望即使是微小的错误也能得到医生的承认，这样做实际上可能会降低惩罚性行动的风险。这些发现加强了患者和医生之间开放沟通的重要性。
BACKGROUND
Mistakes are an inevitable part of the practice of medicine. While the frequency and severity of medical errors are documented, little is known about patients' attitudes toward physician mistakes.
OBJECTIVE
To examine patient attitudes about physician errors.
DESIGN
A survey instrument assessed attitudes to 3 levels of physician mistakes (minor, moderate, and severe) and 2 fundamental physician responses: disclosure or nondisclosure. One hundred forty-nine study subjects were randomly selected from an academic general internal medicine outpatient clinic.
RESULTS
Virtually all patients (98%) desired some acknowledgment of even minor errors. Patient's desire for referral to another physician ranged from 14% following a minor mistake to 65% following a severe mistake. For both moderate and severe mistakes, patients were significantly more likely to consider litigation if the physician did not disclose the error. In the moderate mistake scenario, 12% of patients would sue if informed by the physician vs 20% if the physician failed to disclose the error and they discovered it by some other means (P < .001).
CONCLUSIONS
Patients desire an acknowledgment from their physicians of even minor errors, and doing so may actually reduce the risk of punitive actions. These findings reinforce the importance of open communication between patients and physicians.