[Communication with patients about medical incidents]

Abstract

Errors in medicine are common and often inevitable. They represent a dramatic situation for patients and their families. Thus, the physician-patient communication after a critical incident is crucial to prevent increased trauma. An error disclosure is a difficult, often overwhelming challenge for physicians. Doctors commonly experience enormous pressures from patient advocates and ethicists, who encourage full disclosure while risk managers and liability insurers demand restraint. Despite increasing institutional and legal protections, physicians are still reluctant to disclose errors to their patients. And those error disclosures that do occur often fail to meet patients' expectations. In fact, there is a substantial gap between what patients want to hear and what physicians typically disclose. Previous research has proposed a series of verbal messages doctors should communicate during error disclosures. However, considering the emotional content of such messages, patients likely derive much of the meaning from physicians' nonverbal behaviors. This article presents a detailed review of the existing literature on this topic area and discusses the verbal and nonverbal components that constitute a competent error disclosure in the medical field.