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A Survey of Internal Medicine Patients in an Academic Setting

Amy B. Witman, MD; Deric M. Park; Steven B. Hardin, MD

Arch Intern Med. 1996;156(22):2565-2569.

Abstract
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.

Arch Intern Med. 1996;156:2565-2569

Author Affiliations
From the Department of Internal Medicine, Loma Linda University Medical Center (Drs Witman and Hardin); School of Medicine, Loma Linda University (Mr Park); and Department of Internal Medicine, Jerry L. Pettis Memorial Veterans Affairs Medical Center (Dr Hardin); Loma Linda, Calif. Dr Witman is now with the St Mary's Medical Center, Hobbs, NM.

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