www.mddus.com
“Saying sorry is NOT an admission of legal liability, it is the
right thing to do.” This is a view shared by MDDUS and we would always advise
doctors to offer an apology where appropriate. As a medical adviser, I often provide assistance to doctors who are facing upsetting and troublesome complaints. When advising how to draft a written response to a complaint, I usually recommend that the opening paragraph includes firstly an acknowledgment of receipt of the complaint and secondly an expression of condolence to the complainant and their family for the perceived harm suffered. It is good practice to then assure the complainant that their concerns have been taken seriously and also give an account of the investigation that has taken place. It is also helpful to include a paragraph detailing any lessons that have been learned by the doctors/practice to prevent a similar event happening again. Dr Dorothy Armstrong advocates the 3 R’s approach to
saying sorry:
Regret It is important to recognise that something has gone wrong by acknowledging the wrongdoing, even if you are not at fault. Saying sorry, in a meaningful and sincere manner, is crucial. Often this first step is enough to de-escalate the situation.
Reason Even if you feel criticised and hurt, it’s really important to provide a reason (if there is one) for the mistake, but to avoid being defensive. Make sure you are clear that the wrongdoing was not intentional or personal, so keep to the facts. Try to put yourself in the complainant’s shoes and step back from the situation. Stay objective.
Remedy Try to resolve the mistake there and then, if you can. Ask the complainant what they would like to happen and take responsibility to
investigate, if required, and to provide feedback to them as soon as is practicable. Encourage colleagues to be proactive too. So, back to our opening scenario and what our doctor should do… In this case, it would be appropriate to speak to the patient’s mother
in more detail. Consider an approach such as: “I am very sorry to hear what has happened to your daughter. Why don’t you come in to my room for a minute?” Before beginning a conversation, bear in mind that you cannot say
anything that would breach the patient’s confidentiality. It may be worth thinking back to the consultation – did the doctor take a good history? Was the patient happy with the diagnosis and management plan that was discussed? Regardless of what happened in the consultation, it is important not to be defensive, after all something terrible has happened. Our doctor can be sorry without being guilty. The conversation with the patient’s mother might go something
like this: “You must have had a very distressing and stressful time of it last night. I was the doctor who saw your daughter yesterday, I am really sorry to hear what has happened to her after I saw her. I would like to assure you we will fully investigate what has happened to see if there is anything that I could have done differently at the time and, if so, to stop this happening to someone else. I am sorry for all the upset you have had. Is there anything you would like me to do at the moment to help?” Each situation/complaint is different so advice will vary depending
on the circumstances. If in doubt, contact MDDUS for advice on how to proceed.
Useful resources: • The SPSO:
http://tinyurl.com/mn88qar
• NHS Litigation Authority:
http://tinyurl.com/o8zjqun Dr Susan Gibson-Smith is a medico-legal adviser at MDDUS
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